I am sure your surgical consent form is similar to mine. I write out the name of the proposed surgery (i.e. Austin bunionectomy) and describe it in lay terms. I am going to shave bone, cut bone, reposition bone and use internal hardware. I also have a paragraph for all patients stating that, “I will do any additional surgery or modify the proposed surgery if necessary to obtain the best possible result.” I feel it is important to do whatever it takes to get the surgery done right.
As long as the additional surgery is reasonable, there is nothing to worry about regarding your consent form. For example, I have done an opening base wedge osteotomy and needed to add a Reverdin osteotomy to get a congruous joint. I have also obtained patient consent for an Austin procedure and then realized that I needed to do an Akin procedure (which was not included on the consent form). That is completely acceptable.
Certainly, there is a limitation to what you can do without consent. For example, it would not be appropriate to obtain consent for an Austin bunionectomy and then decide to do an arthrodesis of the joint. To address that potential problem, I will often obtain patient consent with an “either/or” procedure. For example, I may obtain patient consent for an Austin or a closing base wedge osteotomy. Certainly, the postoperative protocol is different. I will tell patients they may wake up with a soft dressing on their foot with a surgical shoe or a cast. They are prepared to be non-weightbearing after surgery if necessary.