Foot Surgery to Correct Bunions—Types and Recovery

A bunion is a painful bony lump on the inside edge of the foot at the big toe joint. About one-third of American adults have a bunion or have had one in the past. They are more common in women and in older adults.

Bunion surgery is often necessary to correct a bunion if pain limits mobility and activity and if conservative treatments fail to bring relief.

What is a Bunion?

 A surgeon and two assistants operate on a patient’s foot in an operating room.

A bunion is a bony lump that forms on the big toe joint on the inside of the foot. This joint is called the metatarsophalangeal joint, or MTP. It connects the phalanx bone in the toe to the long metatarsal bone in the foot. A smaller bunion, sometimes called a bunionette, can form on the outside of the little toe joint.

The lump or bump forms when the toe starts to bend in toward the other toes. This is a condition known as hallux valgus. As the top of the toe bends in, the joint is forced outward, creating the bump.

Bunions form slowly over time, often exacerbated by footwear and standing, both of which put pressure on the toe joint. These lumps can be very painful, although some people live with a bunion for years with no issues. Bunions generally get more severe as time passes.

What Causes Bunions to Form?

Bunions form when pressure on an unstable MTP joint causes the inward movement of the big toe. Experts agree that there is a strong genetic component related to the hereditary nature of foot structure. Family history is present in about 70% of people with bunions.

Family history does not guarantee bunion formation. Other factors play a role and increase the risk:

  • Narrow and poorly-fitted shoes
  • High-heeled shoes
  • Spending a lot of time standing
  • An inflammatory condition in the joint, such as rheumatoid arthritis
  • Congenital deformities

Symptoms and Complications

A bunion is fairly easy to identify. The hard, bony lump on the outside of the big toe is the most characteristic sign. Other symptoms and complications caused by a bunion include:

  • Pain in and around the joint
  • Difficulty walking due to pain in the toe
  • Inflammation and redness on the bump
  • A callus or corn on the bunion
  • Hardened skin on the bottom of the foot

Conservative Treatments for Bunions

Before trying foot surgery, a podiatrist or foot and ankle specialist will likely recommend more conservative options. If these don’t work or provide adequate relief from symptoms, you probably need surgery to stabilize and realign the joint.

For many people with minor bunions, better footwear makes a big difference. Look for shoes that fit properly and have a bigger toe box, and avoid high heels. A pad that cushions the bunion inside the shoe can also relieve pain.

If these measures are not enough, a podiatrist can fit you for orthotics or provide other devices. Orthotics are shoe inserts that provide greater stability and cushioning. A toe spacer or special splint stretches out the gaps between the toes as you sit or during the night. These methods can provide some relief, but they are not permanent solutions.

Do I Need Bunion Surgery?

If you have a bunion that causes pain and other symptoms, see a podiatrist. They can evaluate your foot, take X-rays to look at the joint, and provide non-surgical treatments. If these don’t work, and you still have pain and limited mobility, surgery is likely the best option.

Types of Bunion Surgery

There is a lot of variety in bunions. Doctors choose a type of surgical procedure based on the severity, size, and shape of the bunion as well as individual patient needs. The goals of any surgery are to relieve pain, correct deformities, and realign the joint.

  • Osteotomy
    During an osteotomy, the surgeon cuts into the bone at one or more places along its length. They then use screws or other devices to realign the joint and fix it into a better position. They may also remove a small amount of bone tissue.
  • Arthrodesis
    If a patient has arthritis in the joint, the surgeon may perform this procedure to remove part of the damaged tissue. They then use plates or screws to realign and position the joint. Typically, a surgeon uses this procedure only for severe bunions and arthritis.
  • Exostectomy
    Rarely used alone but often in combination with another procedure, an exostectomy involves the removal of the bump from the toe joint. It is not a fix in itself because it does not realign the joint. It might provide a temporary fix, but the bunion usually returns.
  • Lapiplasty Bunion Surgery
    Lapiplasty is a new patented surgical technology for correcting bunions. It uses a three-dimensional approach to improve on the typical osteotomy, which aligns the joint in two dimensions. It also addresses the instability in the joint that led to the bunion. The procedure is minimally invasive and allows patients to begin walking in a boot in about 10 days.

Recovery from Bunion Surgery—What to Expect

Bunion surgery is typically an outpatient procedure. You’ll be able to go home the same day. Your surgeon will provide recovery instructions and discharge you with a dressing designed to hold your toe in the correct position.

Once you return to the surgeon to have the stitches removed—usually after two weeks—you will get a protective brace or boot to wear. Recovery and healing of the tissue take up to 12 weeks, so your mobility will be limited, and you might need a walking aid. Most patients receive pain medications and do some exercises or physical therapy to speed recovery and manage symptoms.

Our foot surgeons are available to answer any questions you have about bunion surgery. Contact us today and request an appointment to speak to one of our experts about your foot pain.

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