A bunion is a painful deformity of the foot that occurs when the big toe moves in towards the second toe, creating a bump of bone and soft tissue at the base of the big toe. Wearing too-small shoes with pointed toes is a common cause of bunions. Although bunions can be treated without surgery, sometimes nonsurgical treatments are not enough to correct the problem. Bunion surgery, called bunionectomy, can help ease the pain and correct the problem but is not without risks.
Procedures
There are several approaches to bunion surgery. A surgeon can remove the damaged parts of the big toe bone, repair the tendons surrounding the big toe and realign the joint. Most bunion surgery is performed on an outpatient basis. The patient is administered an ankle block anesthesia, which numbs the foot but allows the patient to remain conscious. Surgery usually takes about one hour and the patient is ready to go home one to two hours later.
Types of Surgery
There are many types of bunion surgery. Anthrodesis surgery is the removal of the damaged joint surfaces and the insertion of screws, wires and/or plates. Resection arthroplasty surgery is the removal of the damaged part of the joint itself. Exostectomy surgery removes the bump on the toe joint, and osteotomy surgery realigns the joint. Another surgical procedure involves repairing the tendons and ligaments around the big toe, often used in conjunction with osteotomy surgery. Your orthopedic surgeon will select the surgery that's best for you.
Complications
Although fewer than 10 percent of people experience complications with bunion surgery, there are certain risks involved. Infection can occur and require additional treatment. There is also the possibility that the bunion might reappear after surgery. Other bunion surgery risks include nerve damage, scarring, prolonged swelling, prolonged pain, blood clots, stiffness, a shortened toe, undercorrection, overcorrection and the chance that the wound may not heal properly.
Expectations
Have realistic expectations--bunion surgery has limitations and there is no guarantee that it will completely relieve your pain. After surgery there is often a long recovery period and you may need to spend time in physical therapy. You might also have to use crutches and exercise will be limited to short walks in the first few weeks. Stitches will be removed about two weeks after surgery but your foot will remain in dressings or a brace for up to eight weeks.
The bunion(s) can recur if you return to wearing small or slender shoes after surgery.
Candidacy
Is bunion surgery for you? You might want to consider bunion surgery if you are experiencing toe stiffness, toe inflammation, toe deformity or severe foot pain that interferes with your everyday life. Another reason to consider bunion surgery is if non-surgical solutions such as medications, orthotic shoe inserts and shoe changes have little or no effect on your pain or other symptoms. Consult an orthopedic surgeon to see if bunion surgery is the best option.
