Bunionectomy: A Surgical Treatment for Bunions

What is a Bunion?

Bunions develop when the joint of the big toe is under too much pressure. When this pressure is constant, the toe can become misaligned, which causes it to bend towards the other four toes on the foot. Possible consequences of this misalignment include pain, swelling, and redness of the joint, skin irritation, swelling at the base of the toe, and bending of the toe.

Often, bunions can be treated with non-surgical measures such as wearing corrective shoes, and using over-the-counter medications to relieve pain. For serious cases of bunions, or those which cannot be corrected with common treatments, surgery may be required to remove the bunion. This is an important treatment to consider, as an untreated bunion may eventually lead to the development of arthritis in the affected toe.

Information about Bunionectomy

Surgical procedures to remove bunions can be carried out under general anesthetic, but may also use a local anesthetic which numbs only the foot, or a spinal epidural that numbs the patient from the waist down. This range of anesthetic options means that people who need a bunionectomy are able to get one even if they are unable to undergo general anesthetic for medical reasons.

During the procedure, a surgeon makes an incision over the site where the bunion is located. The bony lump that has formed over the big toe is removed. After the bunion is removed, the toe joint may be stabilized with the addition of one or two screws. These are often added in serious cases, to provide the toe joint with extra stability while it heals. Repairs are made to the cartilaginous “capsule” of the joint if necessary, after which the procedure is complete, and the incision is closed. In most cases, this procedure is completed in an hour or less.

Recovery

For most people, this is an outpatient procedure which requires that they remain at the hospital only for a few hours. In most situations the patient can go home as soon as they are capable of safely walking short distances unaided. Some discomfort or pain should be expected, and perhaps some nausea as the anesthetic wears off.

There is a small risk of blood clots or wound infection after surgery. To reduce the risks patients should try as much as possible to keep the foot raised higher than the knee while they are recovering. Movement is also encouraged, to help improve circulation and further reduce the risks.

For around four to six weeks after the procedure, the patient should avoid walking or standing for long periods of time. Frequent but short bursts of movement and activity are best to reduce the risk of complications and ensure the foot is able to rest and heal.

References

Kaiser Permanent Physical Therapy Residency & Fellowship Program Library: Bunionectomy: Surgical Indications and Considerations

Shannon Erstad, MBA/MPH for WebMD: Bunion Surgery Information and Resources

Shannon Erstad, MBA/MPH for WebMD: Bunions