Home » Treatments » Bunion Surgery

Bunion Surgery

Bunion surgery is a medical procedure in which the surgeon cuts into the inner side of the foot, close to the big toe joint and remove any excessive soft tissue or realigns the bone. This surgical intervention is performed when other non-surgical treatments for bunions did not provide the desired results and it is often done for two purposes: one to relieve the excruciating pain and two, to realign the deformed joint. Sometimes, additional metallic wires might be used to restore the normal alignment of the big toe joint and hold it into place.

Even though there are almost one hundred of bunion surgery procedures available, not one guarantees complete elimination of the problem or the symptoms. The surgeon will decide on the best procedure according to the extent of the deformation and he or she might decide to perform more procedures at once, in order to obtain the best results. The main objective is to correct the existent deformity, thus allowing the patient to resume his or her normal daily activities.

Bunions appear as a direct result of a foot deformity, known as hallux valgus. The big toe actually turns outward, the entire joint being twisted towards that direction. The modifications appear in the area, the joint becomes prominent as there are a lot of excess soft tissue and bone. The most common cause that leads to the appearance of bunions is the prolonged wearing of shoes that are either too small or have a tip that is too tight. Medical conditions, such as arthritis or poliomyelitis can lead to bunions and it seems that there is the possibility of genetic inheritance. However, returning to the primary cause, it is important to mention that women are more affected by bunions than men.

Bunion Surgery Procedure

There are medical approaches when it comes to bunion surgery:

Tendon and ligament repair

This procedure is recommended when there is an imbalance between the lateral tissues around the big toe (too much constriction on one side and too little relaxation on the other side). The surgeon will intervene in order to shorten the relaxed tendon and also to make the constricted one longer.

Osteotomy

This procedure is performed often times simultaneously with the one presented above. The surgeon will make small cuts in the bone, bringing the bones into their physiological and anatomical position.

Arthrodesis

The damaged joint surface is removed and then the surgeon might decide to use wires, screws or plates in order to hold the joint together until the healing process is complete. This is a procedure recommended in patients who have severe deformations in their toes, with large bunions, those who have an underlying medical condition causing bunions (arthritis) or when other surgical procedures have failed to provide the expected results.

Lapidus procedure

This is a variant procedure of the one mentioned above, in which the joint between the metatarsal bone and the mid-food undergoes fusion.

Exostectomy (bunionectomy)

The excessive tissue and bone are removed from the joint and, sometimes, the surgeon might also decide to remove a part of the metatarsal head. This procedure is recommended only when there is a bulge on the side of the toe joint, without any additional deformation. It is not a common course of treatment, as it is believed that it does not correct the actual cause of the bunion.

Resection arthroplasty

The damaged portion of the joint is removed. This procedure is done in elder patients, in those who have already had other types of bunion surgery or in severe cases of arthritis. The joint will retain some of its flexibility, despite the considerable scarring.

Implant insertion

An artificial joint might be inserted in order to replace part or all of the affected toe joint.

Cost

The cost of bunion surgery depends on the geographical location, the facility in which the surgery takes place and the surgeon performing the operation. The overall cost is affected by the type of procedure chosen for your medical condition, the number of hospital days and other healthcare related costs. It is for the best that you check your insurance policy and see what is actually covered. On average, bunion surgery costs somewhere between $3500 and $5000.

Recovery time

The success of the recovery process is guaranteed if you follow the instructions that the orthopedic surgeon has given to you. The dressing care is of utmost importance; as you will leave from the hospital, the recently operated area will have a special bandage that holds the toe in the correct position. Moreover, you might wear a brace or a cast in order to further protect your foot. The sutures are going to be removed in the next couples of weeks but you will probably wear the supportive brace for six to eight weeks.

The healing process should be supported during this period and it is highly important that you maintain the area dry. You should not let water get in that area until it is properly healed. Also, it is very important that you do not bear weight on the said food during the first days after the surgery. You will have to walk using a cane or crutches, bearing weight on that foot only after the wound has healed. If there is a lot of inflammation and pain after the surgery, then you should keep the foot elevated and apply ice packs to the area. Special orthopedic shoes will have to be worn after the surgery and it is recommended that you wait a couple of months before you wear high heels.

Physical therapy is an important part of the recovery period, as a good program can help you increase mobility in the recently operated area and also to strengthen the muscles. The exercises in the first days of the surgery are going to be simple, their complexity increasing gradually as the wound heals and there is a lot more mobility in the area.