Bunion correction surgery is an operation to improve the position and alignment of the big toe. A bunion, or hallux valgus, refers to the appearance of the big toe when it increasingly turns toward the smaller toes. When the big toe turns toward the smaller toes, it creates a bump on the inside of the toe that can make shoe wear painful and difficult.
What are the signs and symptoms of a bunion?
A person who has a bunion may have pain near the big toe joint. The most common location is on the side of the big toe, right over the bump. Numbness and burning in the area is also common.
What causes a bunion?
Bunions can run in families but are also caused when your shoes put your feet in the wrong position. Wearing shoes that are too narrow will eventually force the big toe to turn toward the lesser toes. Eventually, the ligaments may stretch out to a point where a bunion develops.
About one third of adults have this bulge to some degree. How bad the symptoms get depends on the type and the size of the shoes worn. In women, wearing high heels can make bunions worse because they force the toes together. They also put all of the weight on the front part of the foot.
How does a bunion cause pain?
Bunions can cause pain in many ways. The primary source of discomfort is pressure from a shoe over the bump. This causes painful inflammation and may also irritate nerve branches in the area.
What is the treatment for a bunion?
The initial treatment is always non-surgical. This consists primarily of wearing a shoe better matched to the shape of the foot. Wearing a wider shoe made of softer material may provide significant improvement. In addition, commercial pads can be worn over the bump to provide further cushion to the area. But pads will only work if the shoe is significantly wider.
When is bunion correction surgery needed?
If nonsurgical treatment is not effective enough, then surgical treatment can be considered. Surgery is considered as a last resort. It is generally an option only when the symptoms are severe and have not improved with significant shoe wear changes.
Bunion correction surgery comes in many different forms. Which type of surgery is right for a given patient depends on many factors. Plain radiographs are necessary to determine what type of bunion surgery is indicated for each patient:
- For mild bunions, a cutting of the bone close to the joint will often provide good correction of the deformity and relief of symptoms.
- For more severe deformities, the cutting of the bone is done closer to the mid part of the foot. This allows for greater correction.
- If arthritis has developed in a bunion, a fusion of the joint is often the best option. A fusion refers to taking the two bones of the joint and making them a long bone. It is a great procedure for correcting deformity, but it sacrifices motion at the joint.
Joint replacement is currently not a treatment for bunions.
In almost all bunion surgeries, some form of cutting of the bone is necessary, and some use of metal pins, screws, and/or plates are needed to hold the bones in the right position while they are healing.
Risks / Benefits
Are there any risks to bunion correction surgery?
The patient should be aware that there are many risks associated with bunion correction surgery. The most common complications of bunion surgery include:
- A painful scar
- The bunion coming back
- Incomplete correction of the bunion
- Development of arthritis
- Symptomatic or painful hardware
More serious, but fortunately less common, complications include:
- Problems healing the incisions
- Clots in the legs
- Problems healing the bones
In general, only healthy patients without serious medical problems should be considered for bunion correction surgery.
Recovery and Outlook
Do I have to stay in the hospital for a bunion correction surgery?
Bunion correction surgery is performed in an operating room. In most cases the patient will go to sleep for this procedure and also receive some numbing injections to make the foot more comfortable after the procedure. Bunion correction surgery is almost always performed as an outpatient procedure.
What is the recovery like?
The recovery is generally longer than most people would guess. When a bone is cut, it generally takes about 8 to 12 weeks for that bone to fully heal. Therefore, after bunion correction surgery, it is not uncommon for the patient to not be allowed to put all of their weight on the foot for this period of time. Crutches, a walker, or scooter is commonly needed.
It is also common to have to wear a protective sandal or boot to protect the foot while it is healing. After about 3 months, the foot is healed and activity can resume and progress from there. Swelling is one of the most common symptoms that irritate people after surgery. Swelling can last 6 to 9 months after bunion surgery.
What is the outcome of bunion correction surgery?
Once the healing has occurred and swelling is resolved (around 6 months), most patients are able to fit more comfortably into shoes and are happier with the overall shape and function of the foot.