A bunion is a big toe deformity that involves both bone and soft tissue. It is an enlarged bump or abnormal shape that forms at the base of the big toe where it forms a union with the metatarsal bone of the foot.
Bunions can be very painful. They commonly occur from wearing shoes that are too narrow in the toe box area, causing prolonged stress. Bunions can also occur due to arthritis. In people with a bunion, the big toe points excessively toward the second toe.
Bunion formation is more common in women than men, perhaps due to footwear styles that are popular with women. Bunion surgery can provide pain relief if non-surgical treatments do not work. Keeping reading to learn everything you need to know about bunion surgery.
What is bunion surgery?
Bunion surgery, also called a bunionectomy or hallux valgus correction, is a procedure to correct foot deformities by removing a part of the big toe joint. It is offered to patients whose bunion pain prevents them from doing routine activities. For example, many patients with bunions are unable to walk more than a short distance without experiencing severe foot pain.
The procedure is indicated if the big toe remains painful and swollen despite conservative treatment measures like rest, medication, and shoe inserts. The surgery can help relieve pain and stiffness resulting in inability to bend or straighten the big toe. The goal of the surgery is to relieve the symptoms and correct the deformity. It is not a cosmetic surgery and the goal is not to improve the appearance of the foot.
Why do bunions need surgery?
Not all bunions need surgery. You may be able to get relief from non-surgical treatments for bunions. However, bunions should not be left untreated because it can lead to arthritis and chronic pain from deterioration of cartilage in the big toe joint, especially if there is extensive, long-term damage to the big toe.
Why do I need bunion surgery?
If you have severe foot pain even when you've made the switch to flat, comfortable, athletic shoes, then you may need bunionectomy. Surgery may also be recommended if your symptoms of pain and swelling are not relieved by rest and medications. Your doctor may recommend bunion removal if there is a severe change in shape of the big toe joint or you are unable to bend or straighten the big toe.
When should you get big toe joint surgery?
You should consider getting bunion removal done if you have significant pain that limits everyday activities like walking for more than a few blocks. You may need surgery if the metatarsal head toe inflammation and swelling does not improve with rest, pain medication, or change in footwear. You should get the surgery done if there is big toe stiffness and you cannot straighten the toe. Last but not least, surgery is advisable if the deformity is severe, meaning, the big toe is drifting towards the other toes and starting to cross over the second toe.
Is bunion surgery a major surgery?
Yes, bunionectomy is a major surgery in that it can take up to six months to recover from it completely.
How painful is bunion toe joint surgery?
The procedure is done under anesthesia and you will not feel anything. The amount of pain experienced after the surgery varies from person to person. You will experience some discomfort in the first couple of weeks after surgery, which can usually be managed with pain medications. You should follow your surgeon's advice to minimize pain and swelling after bunionectomy.
Can you walk after bunion surgery?
Once the cast or surgical boot comes off, you will need a brace to support your foot while it heals. Initially, you will not be able to put weight on the foot. You will need crutches to assist you with walking. Slowly, you'll be able to put some weight on your foot and use a walker for support. It is important to stay off your feet as much as possible in the weeks after surgery to speed up healing.
How do I prepare for bunion surgery?
During the consultation for the procedure, your medical team will obtain all your health information and perform a physical examination. They may obtain x rays of the foot, a chest x ray, an electrocardiogram, and several urine and blood tests to detect any underlying problems or possible complications with the surgery.
In preparation for the procedure, make sure you tell your doctor about all the medicines, including herbal supplements, that you are taking. Also tell your doctor about any allergies to medications that you may have or any history of bleeding problems. You should also notify your doctor if you are pregnant or could be pregnant.
On the day of the surgery, your healthcare providers will advise you about fasting, depending on what time your procedure is scheduled. You should follow the medical advice to avoid any complications or discomfort.
Bunion surgery is usually done on an outpatient basis and you will be able to go home after the procedure. If the surgery is done under general anesthesia, your doctors will keep you in the hospital for a few hours of observation. Many patients don't need general anesthesia, however. For most people, an ankle block is used to numb the foot below the ankle. In this case, you will remain awake during the surgery but feel no pain.
What happens during bunion surgery?
You will be asked to change into a surgical gown and an IV line will be started in your arm. The skin of the foot will be cleaned with antiseptic solution and anesthesia will be given. Once you are under anesthesia and your foot is numb, the surgeon can perform the bunionectomy in one of these ways:
Osteotomy
This is a type of surgery in which the big toe joint is cut and realigned to a normal position.
Exostectomy
This is a type of surgery in which the bone and connective tissue is removed without aligning the toe joint.
Arthrodesis
This procedure consists of replacing the damaged bones in the toe joint with metal plates and screws to correct the deformities.
Resection Arthroplasty
This procedure involves removing damaged areas to make space between the bones.
After the procedure, the surgeon will place a bandage on your foot and you will be transferred to the recovery room for a couple of hours.
Recovery from bunion surgery
For the first two weeks after surgery, you will need to wear a cast or surgical boot to protect your foot. The surgeon will advise you about keeping the dressing clean and dry. You may be asked to keep the foot elevated on 1-2 pillows to reduce swelling and pain.
You should notify your doctors if you have fever greater than 100.4F, increasing redness or swelling, bleeding, or increased pain in the foot after the bunion surgery.
You can speed up the healing process in the weeks after surgery by keeping off your feet as much as possible. Also, placing ice packs on the foot and toe joint can reduce inflammation during the recovery process.
You will be able to return to activities like driving after about 2 weeks. The initial recovery process from bunion surgery can take 6-8 weeks. Full recovery after bunion removal can take 4-6 months. The foot may remain mildly swollen for several months. Your doctors may advise you to wear athletic shoes with a sturdy heel counter. You will have to avoid high heeled shoes for at least six months after the procedure. You may be recommended physical therapy exercises to strengthen the foot and leg.
Long term outlook, complications, and risks of bunion surgery
Bunion surgery is a safe and effective procedure that is successful in the majority of patients. You should follow all the medical advice to ensure your foot heals properly.
As with all surgical procedures, bunion removal surgery also carries some risks for patients. The most common complications of bunion surgery are swelling, numbness, stiffness, infection, and delayed healing. Rarely, there can be continued pain due to nerve damage. The surgery may occasionally result in over-correction, where the big toe turns away from the other toes.
Do bunions grow back after surgery?
Although unlikely, bunions can gradually return after surgical removal. Some studies have reported recurrence of the bunion in up to 25% of patients.
Finding a doctor for bunion surgery
The MeTime app makes it easy to find a surgeon for bunion removal. You can click and upload pictures and have suggestions sent directly to you. Want to get in touch with surgeons about bunion removal? Try the MeTime app now!
