A bunion is a painful foot condition characterized by a bony bump protruding from the joint at the base of the big toe, according to MayoClinic.com. Causes of bunions can include heredity, shoes with pointed toes, arthritis and wearing shoes that are too small. Bunionectomy, also called hallux valgus correction, can provide relief for painful cases.
When to Consider Surgery
Surgical intervention can help when nonsurgical treatments, such as wearing different shoes, taping and padding, anti-inflammatory medications and shoe inserts, called orthotics, have failed. Those experiencing significant foot pain while wearing reasonable shoes, chronic big toe inflammation, or deformity involving the big toe pointing towards the other toes, may benefit from surgery.
Standard Procedures
The American Academy of Orthopedic Surgeons advises avoiding procedures called "minimal incision" or "simple" because they often remove the bump, resulting in improved appearance, but do not correct the causes of the bunion. The goal of surgery, according to the AAOS, is to realign the joint and correct the deformity. Technique depends upon the particular problems present. Possible procedures are repair of the tendons and ligaments, removal of damaged portions of the joint, insertion of screws or plates, and the surgical cutting and realignment of the joint, called osteotomy.
Mini TightRope Procedure
In a May 2010 article, the National Institutes of Health website, MedlinePlus reported on a new procedure that pulls the bone into place, instead of breaking it. Orthopedic surgeon Dr. George Holmes of Rush University Medical Center developed the procedure, which he calls the "Mini TightRope." The procedure does not involve invasive surgery. Instead, small holes are drilled into two bones in the foot. A strong, thin wire is threaded through the holes and wrapped around both bones and then tightened, pulling the big toe into alignment. Patients can walk after the procedure and are free of pain in a few weeks, Dr. Holmes explains.
Risks and Complications
The May 2010 MedlinePlus article notes that complications occur after 10 to 30 percent of bunion surgeries, while the AAOS reports that fewer than 10 percent of patients have complications related to bunionectomy. Possible complications include infection, nerve damage, continued pain and recurrence of the bunion.
Recovery
According to the University of Maryland Medical Center, most patients return home the same day they have surgery. The AAOS explains that bandages will hold the toe in its corrected position, and a special surgical shoe or cast will protect the foot. Removal of stitches occurs approximately two weeks after surgery. Support from dressings, or a brace, continue for six to eight weeks. Use of a walker, or crutches is required for the first few days. Walking only short distances is recommended for the first few weeks. Physical therapy may be recommended. Visits to the surgeon continue for several months to ensure proper healing.
