Bunions
Bunions are a foot deformity that occurs when the bone in the big toe juts out, becoming large and forming a large bump on the side of the big toe. A bunion, which is composed of tissues and bone, can be extremely painful--and can be made worse by wearing shoes that don't fit correctly, according to the American Academy of Orthopaedic Surgeons. Surgery isn't always necessary, but people with severe bunion pain that can't be improved (or those with a foot deformity that needs correction) may need surgery--and there are several different ways to tackle a painful bunion.
Surgery on the Surrounding Tissues
Ligaments and tendons are the supporting tissues on your big toe, and they can contract and be too tight--resulting in a big toe that pulls in toward the other toes. You can have surgery to lengthen those short, tight tissues and add remove length from the loose tissues on the other side of the toe to treat a bunion.
Repair of the Joint
Sometimes, the actual bones in the joint are damaged, and parts of the big toe joint need to be removed. This type of surgery, called arthrodesis, takes out damaged bone and replaces it with plates, screws or wires to keep the joint in place until the bones have time to heal, says the AAOS. Another type of surgery to repair the joint is called resection arthroplasty, in which a portion of the joint is removed but plates aren't put in place to hold the joint together--instead, the joint becomes more flexible.
Bunion Removal or Joint Realignment
Sometimes, just the bone itself is enlarged and the structure of the toe is fine. In an exostectomy, the bunion itself (the big bump on the side of the toe) can be surgically removed. But, says the AAOS, this surgery doesn't get to the root of what caused the bunion and isn't used often.
When the joint is out of alignment and a bunion forms, surgery may be performed to restructure the big toe joint. Called an osteotomy, the AAOS says that this procedure requires that the joint itself be cut and put back into place to repair a bunion.
