Bunion Surgery Techniques

A bunion is a bump on the joint of the big toe, characterized by pain, swelling or a limited range of movement in the affected toe. Many factors can contribute to the formation of a bunion, including wearing too-tight shoes, genetics or medical conditions like arthritis. Bunions occur when the bones in the big toe shift around due to improperly-distributed pressure on the feet and toes.

Surgical Options

• The pain and discomfort of bunions may be relieved by wearing comfortable shoes and using padding, pain relievers and ice packs. However, bunions are permanent unless corrected by surgery. If standing or walking without pain is impossible due to severe bunions, corrective surgery might be the best option. Surgery to correct the deformity caused by a bunion is known as a bunionectomy. The components of a bunionectomy vary according to the severity of the bunion. In an exostectomy, a surgeon shaves the bump off of the bone. This is usually not effective on its own, as the bunion may grow back after surgery. Thus, a surgeon will often pair an exostectomy with an osteotomy on the affected toe bone. In an osteotomy, a surgeon repositions the bones of the big toe, often by removing part of the bone. One osteotomy variation is a chevron osteotomy, in which a V-shaped cut is made in the bone and a screw is surgically inserted to hold the bone in place. Another variation, the Myerson/Ludloff procedure, involves the use of more than one screw to properly position the bone. In a Lapidus procedure, used to correct severe bunions, a surgeon fastens the toe bone with screws to the main part of the foot to stabilize the bone. Some patients with foot bones damaged from arthritis undergo an arthroplasty instead of an osteotomy. In this procedure, the joint of the big toe is either fused or removed, and the toe is surgically reshaped.

Possible Side Effects and Complications

• Bones heal in about six weeks after surgery. For six to eight weeks following a bunionectomy, a patient might need to wear a cast or a specially-designed shoe to protect and stabilize the foot and toes. Side effects from bunion surgery may include swelling, scarring or a recurrence of the bunion. Some individuals suffer an allergic reaction to the screws placed in the foot bones during surgery. Other dangers include infections in the bones or tissues. Patients should promptly tell a doctor about any abnormal pain, fever, or bleeding or leaking at the incision site, as these could be indications of a serious reaction to the surgery.