What is bunion correction surgery?
Bunion correction surgery, also known as bunionectomy, is a surgical procedure designed to correct a bunion deformity in the foot. A bunion (hallux valgus) forms due to a misalignment of the big toe and often looks like a bony bump on the joint at the base of the big toe. Over time, bunions can progress and grow larger, causing pain, inflammation, stiffness, and even deformity.
Bunions are a common foot problem, and Penn Medicine foot and ankle orthopaedic specialists are highly experienced in treating them. If you have a bunion, our orthopaedic team will work with you to see if nonsurgical approaches can be effective in treating pain and discomfort. Bunion correction surgery, also known as a bunionectomy or bunion removal, may be recommended for more severe or complex cases.
Every bunion surgery is different depending on the severity of your symptoms and whether your bunion has progressed to a deformity. Your doctor will discuss the details of the recommended surgical approach and answer any questions you have.
Types of bunion correction
Treatment for bunions depends on the severity of your symptoms and your health history. If conservative, nonsurgical treatment doesn’t reduce the pain caused by your bunion, surgery may be the next step.
Whenever possible, our orthopaedic specialists use conservative therapies to treat bunions. We may recommend icing the area or using anti-inflammatory medications to help reduce swelling.
Simply changing your footwear can reduce symptoms significantly. Avoid wearing narrow shoes and high heels and opt for a wider shoe with padded heels or padding inside the shoe. A toe spacer can help the big toe stay in place and prevent it from moving outward. Custom orthotics or custom insoles, created by Penn Medicine specialists, may also help keep the toes and foot aligned, relieving symptoms and preventing the bunion from progressing.
Patients with mild to moderate bunions who have not found relief from conservative management may be candidates for minimally invasive bunion surgery. The most common type of minimally invasive surgery is called an osteotomy, which is used to reshape damaged bones or joints. Your surgeon uses small incisions in the foot to access the bone behind the big toe (first metatarsal) and change the bone’s alignment. This procedure often results in faster recovery times and less scarring than conventional surgery. Your doctor will assess the severity of your bunion and decide whether minimally invasive surgery is right for you.
A conventional bunionectomy is a more complex surgery that involves realigning the big toe and is usually reserved for more severe cases. Several different types of procedures may be needed in conjunction with one another for this type of bunion correction surgery. It can include removal of bone and soft tissue, along with repairs to ligaments, tendons, and nerves. Bone fusion, also known as arthrodesis or lapidus procedures, may be part of the surgical plan.
Who is a candidate for bunion correction surgery?
When nonsurgical approaches don’t reduce the pain caused by your bunion, you may be a candidate for bunion surgery, especially if you are experiencing any of the following symptoms:
- Significant big toe pain, swelling, redness, and stiffness
- Difficulty walking
- Pain from certain types of shoes or difficulty finding shoes that fit properly
- Decreased movement in the big toe
Bunion surgery is a personal choice. You and your physician will discuss your goals for the surgery, risk factors, and any other lifestyle factors that need to be considered before making the decision to move forward with surgery. Your surgeon will discuss whether you are a candidate for minimally invasive surgery or a conventional bunionectomy.
What to expect during bunion surgery
Bunion removal is an outpatient procedure. Leading up to the surgery, you’ll have a medical exam and may need blood tests, imaging tests, and an EKG to be sure you are ready for the procedure. Consult with your doctor about any medication restrictions or fasting required prior to surgery.
On the day of the surgery, you’ll receive local anesthesia, so you’ll be pain-free during the procedure. You’ll be awake during surgery to help you recover more quickly, have a lower risk of side effects and complications, and avoid the need for an intravenous (IV) line.
Your surgeon will make an incision near the big toe joint and remove pieces of the bone while straightening out the toe joint. The bone is then set in a position that properly aligns the big toe. Hardware such as pins, screws or plates may be used to hold the toe in place. In patients with arthritis, bone fusion may be performed to remove the arthritic joint and damaged cartilage.
The length of surgery varies depending on its complexity. Generally, surgery lasts less than an hour.
Recovery from bunion surgery
The recovery time after bunion correction surgery differs significantly for conventional and minimally invasive surgeries. Because you’ll need to stay off your foot for a time, it’s best to avoid bunion correction surgery on both feet at the same time.
Because of the complex nature of conventional bunion surgery, recovery may take several months. Generally, you should plan for up to six months or more of recovery time to allow the bones and soft tissues to heal.
You may need to wear a special shoe, use crutches, or use a wheelchair during this time. We’ll monitor you throughout your entire recovery, seeing you regularly to ensure you are healing properly. We will recommend physical therapy at the appropriate time based on your progress and provide additional treatment to manage any discomfort.
You’ll be able to bear weight on your foot while wearing a boot immediately after surgery. After five or six weeks, you may be able to return to regular shoes and begin physical therapy. Your doctor will see you regularly during your recovery period to assess your progress, recommend physical therapy, and provide additional care to help you get back to your regular activities as soon as possible.
Risks of bunion surgery
Bunion correction is considered safe and can significantly reduce the pain and discomfort associated with bunions. Like most surgeries, there are some risks that may include:
- Infection
- Swelling, stiffness, numbness, or nerve damage
- Residual pain that does not resolve
- A bunion that returns
Talk with your doctor if you have questions about the risks of bunion surgery.
Experts in bunion care
Penn Medicine’s orthopaedic providers are experts in treating bunions—whether through conservative methods or surgery. Our multidisciplinary team includes orthopaedic surgeons, physical therapists, and physiatry specialists who work with you to assess your situation and create a treatment plan to reduce your painful symptoms.
We offer many options for bunion care and take a “whole person” approach, using a shared decision-making process with you. This helps us stay focused on the best possible outcome. Bunion treatments are available throughout the southeastern Pennsylvania and New Jersey regions, offering exceptional care close to home.
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