What is a Bunion?
A bunion is often described as a protruding "bump" on the side of the big toe. The visible bump actually reflects changes in the bony framework of the metatarsal bone (the long bone behind the big toe joint). These changes reshape the bone causing the bulge. Changes to the metatarsal bone also cause the big toe to lean toward the second toe.
When this occurs, it further throws the metatarsal bone out of alignment, worsening the protrusion and bunion “bump.” An inflamed bunion can be quite painful, and even the roomiest shoes may be uncomfortable.
Changes to the metatarsal cause the muscles, tendons, ligaments, and other components of the big toe joint to become contracted and misaligned as well. Over time, this can lead to stiffening of the joint and arthritis, with wearing down of the cartilage lining the joint surface.
Bunions can compromise the alignment of the other toes causing discomfort and hampering normal activities. As the deformity progresses the great toe leans even more, often resulting in hammertoes.
During your consultation, we will discuss the most appropriate treatment for your bunion and other related deformities that may have developed and the appropriate procedures necessary to achieve your goals. Bunions that aren’t painful and don’t interfere with normal functioning may be treated by switching to roomier shoes, using anti-inflammatory medications, cortisone injections and/or orthotic devices that relieve pressure and realign the biomechanics of the foot.
When these steps do not offer relief and you have persistent pain and deformity, surgery may be indicated and recommended. Other indications for surgery include limitation of activities, difficulty with fitting shoes, and cosmetic concerns.
Our goal is to restore alignment and function and improve your quality of life. We make every effort to have you return to shoes quickly. Most of our patients are able to walk immediately after the procedure in a protected shoe or boot and return to a sneaker type shoe at their first post-operative visit in 10 days.
Prep and Procedure
Your evaluation will begin with a standing x-ray of your feet, which we will analyze for the angular degree of deformity as well as the quality of the bone and joint. We will integrate these findings with your lifestyle and activity level, and draw from a combination of surgical techniques to offer the best outcome. We will discuss all aspects of the surgery and draw a detailed picture of the procedure to be done. We find that educating our patients and helping them understand how we will be helping them improves their healing and overall outcome.
We perform the surgery under sedation with local anesthesia administered by our anesthesia staff at our hospital. Our patients are assured of a pain-free procedure.
We use the most advanced low-profile fixation of the bone which promotes rapid healing and return to function. Our approach ensures that our patients will not experience any sensation from screws or other devices and there is no impact on metal detectors. Full and natural motion will be restored to the joint, and shoes - including dress shoes - can be worn with more comfort than before.
During the procedure, your surgeon removes excess bone and shifts the metatarsal back into proper alignment which straightens the big toe. We utilize plastic surgery skin techniques to minimize scarring and as adjuncts to improve alignment. Our surgical plan for you is to facilitate your recovery with a rapid return to function with improved motion.
You will go home the same day after the procedure with the local anesthetic lasting for many hours after you arrive home. Prior to your surgical date, we will provide you with a prescription for pain medication so you can be assured of a comfortable recovery.
We are happy to offer second opinions and are qualified experts in corrective procedures.
We are attentive to pain management for the post procedure period and most patients have minimal discomfort and are pleasantly surprised by their recovery.
You will be discharged the same day as your surgery. As soon as your surgeon and the team are satisfied that you are ready to go home, we will give you a surgical shoe or boot to wear to help keep pressure off your foot. Crutches or a cane may be recommended to help in this purpose. Sometimes we recommend a cast to be worn for a brief period in order to achieve the optimal result. This will depend upon the degree of deformity and will be discussed at the time of consultation, well in advance of your surgery.
Patients are able to walk around their home the same day as their surgery. Within a couple of days you will be up on your feet and out the door, as long as you take appropriate measures to protect the foot. Your first follow-up appointment after surgery will be in 10 days, at which time we will take x-rays to evaluate healing. Many patients can resume wearing sneakers at that time. We continue to monitor you over the next weeks and months and when healing is complete you can resume full sports and running, with improved function and alignment.
We are available to discuss your progress and any questions you may have as we monitor your recovery.
FAQ- Additional Questions You May Have About Bunions and Bunion Surgery
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