A bunion is a misaligned metatarsal phalangeal joint (the joint that connects the 1st long bone of the foot to the big toe). Bunions often occur when the joint is stressed. Bunions are much more likely to form in women, primarily because women are prone to wear pointed and/or tight shoes.
Treatment before Surgery
First line treatment for bunions is not surgery. There are many options to try before considering surgery. You can try wearing well-fitted, comfortable shoes. Using a stretching device to stretch your shoes is another option.
Cushioning where the shoe rubs against the bunion could be effective. Using a spacer between the big toe and the second toe may relieve the pain. There are splints and orthotics your physician may prescribe. If all of these options leave you still with disabling pain, surgery could be your next option.
One note: Surgery is a last resort for treatment of bunions. The purpose of surgery is to relieve disabling pain. This is not a cosmetic procedure. In fact, patients may need to wear only certain types of shoes for the rest of their life. If your physician believes surgery is your best option, there are a few different bunion surgeries that could be performed.
Osteotomy
An osteotomy involves cutting the bones at the metatarsophalangeal joint and realigning them. Then, pins, screws and/or plates are used to keep the bones in place. Sometimes a wedge of bone needs to be removed to properly align the toe.
Arthrodesis
Arthrodesis is also called fusion surgery. This procedure is often done if there is osteoarthritis associated with the bunion. The surgeon removes the arthritic joint surfaces and then fuses the joint with screws, wires or plates.
Exostectomy
Exostectomy is when the surgeon removes the bump from the joint. This type of surgery is not done often because it does not fix the malalignment that causes the problem. This procedure is instead usually done in conjunction with one of the other bunion surgeries.
Recovery
After surgery, the patient is sent home with bandages in place, keeping the toe in its correct position. Proper bandage changes are essential to obtain alignment of the toe. Stitches are removed two weeks after surgery. Yet, dressing support or a brace are required for six to twelve weeks.
The foot will have to be elevated as much as possible for a few days after surgery. It depends on the type of surgery done as to how long a patient must have no weight bearing. Keeping off of the foot is accomplished by crutches or a knee walker. A knee walker is a four wheeled device where the knee is placed on a padded cushion and the patient scoots along using the healthy foot.
Following the physician’s instructions during recovery is of the utmost importance if the surgery is to be successful. The chances of bunions recurring after surgery are less than 20%.
Let’s Have a Conversation:
Do you have bunions? If so, what type of treatment does your physician advise? Have you had bunion surgery? What was your experience like?
