Bunions, also called hallux valgus, are painful bony bumps. They usually form around the joint at the base of the big toe, and sometimes the little toe. Women are more likely to develop bunions due to wearing tight shoes. However, tight shoes is not the only cause. Bunions can develop as a result of arthritis, prolonged stress on the joint, and heredity. Bunion surgery can correct the bunion and reduce pain caused by the bunion. However, there are non-surgical treatments. So, you need to decide: bunion surgery or treatment?
Non-Surgical Bunion Treatment
Prior to surgery, your podiatrist may recommend other treatments. There are several to try before deciding on surgery.
- Splints or Orthotics: These devices may help by repositioning the toe and padding the toe.
- Changing Shoes: By wearing a properly fitted, comfortable shoe, you will decrease pressure to the bunion causing less pain.
- Medication: Acetaminophen, ibuprofen or naproxen sodium may help with pain. In some cases, your podiatrist may feel that a cortisone injection may help.
- Icing: Applying ice to your bunion can reduce inflammation and soreness.
Types of Bunion Surgery
Your podiatrist may consider surgery if these non-surgical treatments do not help. They type of surgery will depend on several factors. Factors that will be considered are age, health, activity level, condition of the bone and connective tissue around the bunion and the severity of the bunion. There are four main stages of bunion surgeries.
- Mild Surgery: Removal of portion of bone that is enlarged. Muscles, tendons and ligaments surrounding the joint will be realigned.
- Moderate Surgery: Cutting and moving the bone to the correct position. Muscles, tendons and ligaments surrounding the joint will be realigned.
- Severe Surgery: Combines the Mild and Moderate surgeries. Bone will be removed, cut and placed in the correct position. Then muscles, tendons and ligaments surrounding the joint will be realigned.
When arthritis has caused a bunion, the surgeon may find that the joint may not be able to be repaired. In this situation, the surgeon may determine that the joint needs to be fused. A fusion of the toe will remove the ability for the toe to move and cause pain and give the bone time to heal. Joint replacement may also be considered if the toe needs to be reconstructed.
Bunion Surgery Complications
All surgeries come with risks and complications. After surgery, you are at risk for the following:
- Swelling at the surgical site
- Stiffness of the affected toe
- Numbness of the affected toe
- Nerve damage
- Recurrence of the bunion
Contact your surgeon immediately if the incision site is draining, bleeding, red or swollen. You should also contact your surgeon if you have a fever 100.4 or higher, increased pain around the incision, or swelling in the lower leg.
Before, During and After Surgery
If you and your podiatrist decide to move forward with surgery, you can expect several things to happen prior to surgery. You will also need to pay close attention to your post surgical instructions.
First you will meet with your podiatrist and the procedure will be explained. You will be given a list of risks that could happen during and after surgery. Then you will be given a chance to ask questions about the procedure and recovery.
During this visit, you will also need to sign a surgical consent form and complete a medical history form. At this visit, you should discuss other surgeries with your podiatrist, especially if you had any complications with anesthesia. Tell your podiatrist about all medications you are taking and about any allergies. All allergies are worth mentioning, but be specific about medication, latex and adhesive allergies.
Your surgeon may also complete a physical exam to ensure you are healthy enough for the surgery. At this time, you should tell your surgeon if you are pregnant or if you think that your might be pregnant. Your physical exam may include blood tests, x-rays, EKG or other tests.
Prior to going in for the surgery, you surgeon may request that you fast for 8 – 12 hours. You may also be told not to take any medication for a certain length of time prior to the surgery.
You will also need to bring a drive with you to the facility. Your driver should be at least 18 years old and be able to understand post-op directions.
You can expect to have your surgery in an outpatient surgical center or in a hospital. The majority of bunion surgeries do not require an overnight stay.
You can expect the surgical staff to ask you when the last time you ate or drank. Next, you will be asked to change into a gown provided by the facility. Then, you will have an IV started. You may be given a calming medication to relax your nerves through the IV.
Once you are relaxed, your foot will be prepped for the procedure. First, the area will be cleaned with an antiseptic. Then, you will received the local anesthesia. After waiting until you can not feel your foot, the surgeon will begin the procedure.
Lastly, the surgeon will suture the opening and dress the incision site with a sterile bandage.
Recovery is decided based on the surgery and the patient. You will be taken to a recovery room and observed by medial staff. They will observe your breathing, blood pressure, pulse and alertness. The medical staff will also monitor the circulation and feeling in your foot.
Before you are discharged, you will be given a surgical shoe and shown how to put it on and how often to wear it. You will also be given instructions for taking care of your foot. These instructions may include:
- rest and elevation of the foot
- ice application
- limited walking
- cleaning and dressing
- how to keep the area dry
- pain relievers
- driving restrictions
- exercises or physical therapy
- shoes to avoid
- follow up visit for suture removal
- postoperative follow up
Who Can Do My Surgery
If you are in the Livonia, Southfield, Novi or Howell area, our board certified podiatrist are trained in bunion surgery. If you have more questions about bunions or just need a consultation, please contact us today.