Structural deformity of the bones and the joint between the foot and big toe is called the bunion. A bunion is a bony swelling around the joint at the base of the big toe (metatarsophalangeal joint). Due to this, the big toe may turn in toward the second toe (angulation). On the bump of the bunion, the skin and tissue can become inflamed, swollen, and painful. A fluid filled sac, bursa protects the joint of the big toe. In bunion problems, rubbing against the joint can cause the sac to become inflamed, swollen and sore. This condition is known as bursitis. A bunion is a symptom of a hallux valgus deformity.
If discomfort is severe enough or when correction of the deformity is desired, surgery by an orthopedic surgeon or a podiatrist may be necessary. In bunion surgery, an incision in the top or side of the big toe joint is carried out for the removal or realignment of soft tissue and bone to relieve pain and restore normal alignment to the joint. In surgery, severely deformed joints may be stabilized with tiny wires, stitches, screws, or plates. There is no guarantee of fully relief of your pain.
For bunions, over 100 surgeries are available now. Research does not indicate the type of surgery which is best-surgery needs to be specific to your condition.
The general types of bunion surgery include:
- Realignment of the soft tissues (ligaments) around the big toe joint
- Fusion (arthrodesis) of the big toe joint
- Fusion of the joint where the metatarsal bone joins the mid-foot (Lapidus procedure)
- Removal of part of the metatarsal head (the part of the foot that is bulging out). This procedure is called exostectomy or bunionectomy
- Removal of bone from the end of the first metatarsal bone, which joins with the base of the big toe (metatarsophalangeal joint). At the metatarsophalangeal joint, both the big toe and metatarsal bones are reshaped (resection arthroplasty)
- Removal of a small wedge of bone from the foot (metatarsal osteotomy) or from the toe (phalangeal osteotomy)
- Implant insertion of all or part of an artificial joint.
Recovery tips after the bunion surgery:
After the surgery treatment, post-operative care is very important to ensure that the bunion does not reoccur. Depending on the amount of soft tissue and bone affected, the usual recovery period after bunion surgery is 6 weeks to 6 months. Complete healing from bunion surgery may take as long as 1 year. Supportive devices are usually necessary to encourage the foot to heal correctly.
- To keep the stitches dry, the foot must be kept covered when you are showering or bathing.
- Pins that stick out of the foot are usually removed in 3 to 4 weeks, but in some cases are left in place for up to 6 weeks.
- You may need to wear special shoes, wooden shoes, splints, or even a walking cast to help you get around.
- Regular shoes can sometimes be worn in about 4 to 5 weeks, but most surgeries require wearing special shoes up to 8 to 12 weeks after surgery. Many activities can be resumed in about 6 to 8 weeks.
- Stitches are removed after 7 to 21 days.
- You will also be able to resume many of your regular activities by the time that six to eight weeks pass.
- After some procedures, no weight can be put on the foot for 6 to 8 weeks. Then there are a few more weeks of partial weight-bearing with the foot in a special shoe or boot to keep the bones and soft tissues steady as they heal.
- After completing your surgery, your ability to walk around and do activities will probably improve.
Even though the pain may be reduced and the toe is straighter, about a third of people who have had surgery to be disappointed with the results of their surgery. With this surgery, some risks are also involved. The risk involves infection in the bone or soft tissue of the foot. The anesthetic medicines or other medications to control pain may cause side effects. The bunion surgery may not be successful and you may have the bunion come back. Some forms of the surgery may result in a restricted movement or a stiffness of the big toe joint. Arthritis or Degenerative joint disease could be possible following surgery, as could avascular necrosis, which is a interruption of the supply of blood to the bone following the surgery. At last, there could be a development of a callus at the bottom of your feet.
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