A bunion is an abnormal bump made from bone that occurs on the joint at the base of the first metatarsal, also known as the big toe, according to MayoClinic.com. The joint becomes enlarged and forces the big toe over toward the other toes, which puts pressure on the joint, causing pain. Bunions can be hereditary, result from arthritis or can occur from wearing ill-fitting shoes. While painful, there are several operations that can be done to help correct the deformity.
Chevron Osteotomy
A Chevron osteotomy is typically performed to correct a mild to moderate bunion, according to footeducation.com. The procedure involves making a V-shaped cut in the first metatarsal, and the bone is straightened out, reducing the angle between the first and second metatarsal. The joint capsule is also tightened to aid in correction of the bunion. Full recovery typically takes approximately nine to 12 months, but 80 percent recovery is usually seen three to four months post-surgery, says footeducation.com. Complications of a Chevron osteotomy can include malunion of the bone, where the bone has healed in an abnormal position, and recurrence of the bunion.
Lapidus Procedure
The Lapidus procedure aims to move the metatarsal bone back to where it should typically be, according to uclahealth.org. This surgery realigns the metatarsal joint at the midfoot and screws hold the bones together, enabling fusion to occur. This fusion prevents laxity of the joints, which prevents recurrence of the bunion. Recovery time is typically six weeks of no weight bearing to allow complete fusion, and normal activities can usually be resumed three months post-surgery.
Proximal Metatarsal Osteotomy
A proximal metatarsal osteotomy involves cutting the bone at the base of the first metatarsal and rotating it, says footeducation.com. There are various osteotomies that may be performed, based on the type of cut, but all of the procedures aim to reduce the angle between the first and second metatarsal. Different osteotomies include the Ludloff osteotomy, the Crescentic osteotomy and the SCARF osteotomy. Typically, a soft tissue procedure will be done concomitantly to help release tight tissues on the outside of the first metatarsal and tighten the soft tissues on the inside. The soft tissue procedure is known as the McBride procedure, according to footeducation.com.
Great Toe Fusion
A great toe fusion procedure involves fusing the big toe so that it is completely immobile. This ensures that the joint is aligned. According to footeducation.com, this procedure is typically only done in patients who have significant arthritis or as a salvage procedure for those with very severe bunions. Recovery usually takes six to twelve weeks, and complications that may occur include malposition or nonunion of the joint.
