There are certain conditions that potential patients must meet in order to be considered for bunion surgery. Whilst it may be an aesthetic issue for some, a bunion is not always significant enough to require removal. Some of the reasons why people have to undergo bunion surgery include:
- Severe pain in the affected foot that inhibits proper walking and independent movement. People with large, painful bunions often find it difficult to walk, jog or run regardless of the kind of shoes they are wearing.
- Severe pain in the toes that cannot be relieved with physical therapy or painkillers.
- Toe immobility or the individual’s failure to move or bend the affected toe.
- Deformity, wherein the big toe bends inward in the direction of the small toes.
Different types of bunion surgery
There are several types of procedures that may be performed to correct toe deformity and realign the joint. These include:
Exostectomy – involves the removal of the protruding bone on the joint of the toe. This is performed only when the bone is enlarged but the big toe does not drift inward.
Resection Arthroplasty – in this procedure, the damaged joint is removed so there is some space between the bones of the toe. This ‘scar’ joint remains flexible to allow for better movement for the patient. This type of surgery is usually recommended for elderly patients, those who have severe arthritis and patients who have undergone bunion surgery before.
Arthrodesis – involves cutting or shaving of the damaged surfaces of the joint to remove them. The joint is held together using plates, screws or wires.
Osteotomy – involves cutting the bone of the foot near the joint and realigning it to relieve pain. Techniques used for this operation vary, depending on the severity of the condition and the procedure itself may even be done in conjunction with shaving the bunion itself.
Tendon and/or ligament repair – this operation creates a balance between the tissues on both sides of the big toe. Once the tissues are the right length, the toe can move more comfortably.
What to expect pre-, during and post-surgery
An orthopaedic surgeon will perform a thorough physical checkup of the patient and examine his or her medical history. X-rays of the affected toes will also be taken to determine the extent of the problem. Once the patient is cleared, the surgeon then discusses the type of bunion surgery that will be done and the kind of risks the patient can expect.
Before the operation, certain tests will be taken, including blood tests, X-rays and a cardiogram. The bunion surgery itself may be performed using ankle block anaesthesia, wherein the patient is awake but does not have feeling from the area of the ankle to the foot. Occasionally, general anaesthesia may be used. The operation itself may last for an hour.
Bunion surgery is usually an outpatient procedure and the patient may be discharged 1-2 hours after surgery. The patient recovers at home wearing bandages, a cast or a surgical shoe. It may be difficult to walk during the first few days, so the patient may have to use crutches, a walker or a cane. In a week, he or she may be well enough to perform the usual chores, such as walking short distances and driving. The recovery period may last from 6 weeks to about 6 months.
