One of the most common foot abnormalities is a bony bump that develops around the joint or base of the big toe or the little toe, scientifically known as Hallux Valgus (a Latin term meaning “foot deformity”).
Bunionette, or Tailor’s bunion, is a type of bunion that occurs on the joint of the big toe. A bunion can develop as a result of wearing shoes that are either too tight or too narrow on the big toe joint for an extended period of time.
However, this condition can run in families or be brought on by certain types of arthritis, and is more commonly seen in women than men due to the fact that they are more likely to wear shoes like these (tight, confined & pointed shoes).
Bunions can be extremely painful and cause a variety of problems, including difficulty finding footwear, foot deformity, and more.
Many doctors and researchers believe, however, that shoes may worsen the situation rather than alleviate bunion formation. For most bunions sufferers, simple methods such as reducing pressure on the big toe joint help alleviate their discomfort.
Your doctor may advise you to wear shoes that are not only comfortable, but also help maintain the shape of your foot post-surgery. Splints/Orthotics are specialised shoe inserts that aid in foot reshaping.
When arthritis is the cause of a bunion’s pain and swelling, medication may be prescribed. You may be advised to have Bunion removal surgery by your doctor if the condition worsens and simple treatment does not work.
Removal of a bunion serves a functional purpose: it alleviates painful swelling, helps to restore the foot’s natural shape to the greatest extent possible, and serves no purely aesthetic purpose.
Patients’ age, health, and activity level are taken into consideration when deciding on a surgical procedure. Bone and connective tissue conditions are also taken into consideration. The following are possible determinants of surgical procedure selection:
Patients with mild bunion deformities can have their big toe joint realigned by performing surgery to remove any extra bone or soft tissue growth.
Surgeons may cut the enlarged bone and shift it back to its natural position, all while protecting the tendons and ligaments around the joint. The need to cut the bone was determined by the degree and location of the deformity.
When a patient has a severe bunion, removing the enlarged bone portion, cutting and realigning the bone, and realigning tendons & ligaments may be necessary.
As seen in arthritis, in some cases the joint may be damaged beyond repair/treatment and may necessitate a joint fusion in order to be treated.
This aids in bone healing and reduces/eliminates bone movement and pain. Implant replacement may be recommended for big toe reconstruction.
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Is Surgery Right for You?
As previously mentioned, a mild bunion can be treated without surgery using non-invasive methods.
However, if left untreated for a long period of time, the bunion can worsen, but its progression can be slowed down by wearing comfortable shoes that are properly fitted but do not put pressure on the toe joints.
When considering bunion surgery, it’s important to keep in mind that it should not be done solely for aesthetic reasons. The following are common characteristics among those seeking bunion surgery:
- Irritable swelling and chronic inflammation around the joint of one’s big toe.
- Foot deformities such as crossed toes are caused by the big toe bending towards the smaller toes.
- Wearing shoes and walking can be severely disrupted by pain in the big toe joint of the foot.
- Toe stiffness refers to the inability to bend or straighten the toe.
- NSAIDs like ibuprofen, whose effectiveness can vary from patient to patient, are unable to provide pain relief.
Is Bunion Surgery on Your To-Do List?
Almost everyone who has had bunion surgery reports reduced pain and an improved ability to engage in activities of daily living that they otherwise would not have been able to do.
Prior to undergoing bunion surgery, keep in mind that some of the so-called mild treatments or minimal surgical procedures that claim to heal your foot are actually ineffective and might even do more harm than good when you research your options.
It is possible to have bunion surgery on the same day, and your doctor will not require you to stay in the hospital afterward; however, you should be prepared for a lengthy recovery period.
It can take anywhere from a few months to a year for you to fully recover, depending on the severity of your condition and how frequently you see your doctor.
It’s important to remember that bunion surgery will not help you wear pointed or restricted footwear; you may need to limit your footwear choices to those that are comfortable and don’t cause you any pain or discomfort.
Before deciding whether or not to have this surgery, ask your doctor the following questions: Consult with your surgeon to learn about the advantages and disadvantages of having this procedure performed.
These questions will help you to get a clear mind and decide if you are ready to have Bunion Surgery or not. However, if this is not the case and you are still unsure, you should consult your physician.
Do Bunion Operations Carry Any Risks?
Bunion Surgery, like any other surgical procedure, can result in complications. The following are some potential side effects or risks associated with bunion surgery:
- A stifled toe joint.
- A tingling sensation in the lower leg.
- Swelling.
- Healing could be slowed or take a longtime to complete.
- Infection.
Other issues that aren’t common for most people include:
- Bunion recurrence.
- Nerve damage and excruciating pain as a result of operating machinery.
- Overcorrection of the toe, i.e., the big toe bending away from the smaller toes or in the opposite direction, can occur during surgical procedures.
As with any medical procedure, there may or may not be additional risks, so please discuss them with your surgeon prior to the procedure.
Getting Ready for Bunion Surgery
If you’ve made the decision to have your bunion surgically removed, you’ll first need to have a number of medical tests performed to determine your overall health. You’ll be asked to take the following test by your doctors:
- Radiation to the chest.
- An electrocardiogram (ECG) will be performed to determine whether or not your heart is functioning properly.
- We’ll have a urine and blood sample taken to see if we have any underlying health issues.
A few days before and after surgery, your doctor might ask you to stop taking any medications, especially blood-thinning drugs like aspirin, to avoid any possible complications.
Before and after surgery, your doctor will tell you what you can and cannot eat and drink, and how long you need to fast, based on the results of your tests. You must carefully follow your doctor’s instructions in order to avoid any complications.
Bunion Surgery Surgical Procedures
The following are some of the most common aims of various surgical procedures for the removal of bunions:
- The first step is to realign the Metatarsophalangeal joint, which is located at the base of the big toe.
- To alleviate the discomfort and swelling caused by the injury.
- To make up the big toe and foot to correct a bone deformity.
Depending on the shape and size of a person’s bunions, a variety of procedures are used to correct them. In most cases, the enlarged bone is realigned, and soft tissue repairs around the joint are also performed.
Depending on the type of bunion you have, your doctor will be able to give you a more detailed explanation of your surgical options.
Injuries to the Big Toe’s Tendons and Ligaments
There are many reasons why the big toe can become bunionized, but one of the most common is that the big toe’s soft tissues around it are imbalanced, which can cause a toe to drift toward one of the smaller toes, leading to a Bunion.
Tendon and ligament repair entails shrinking long, slack tissues and lengthening short, slack ones. Osteotomies can only be avoided in extremely rare cases (bone alignment).
Bunion surgery often includes more than just a soft-tissue correction procedure.
Osteotomy
Small cuts in the deformed bone are used to realign it during this procedure. In order to repair the bone breaks, either pins, screws, or tiny plates are inserted after the cuts have been made. A balanced joint and straightened bone are the results of the procedure.
Osteotomies may be performed in a variety of locations along the bone to correct the bone deformity, while in some cases small wedges of bone are removed to straighten the toe after making cuts on the bone.
Osteotomies are commonly performed in conjunction with soft tissue repair surgery in most cases.
Arthrodesis
To aid in healing and straightening the bones, pins, screws, wires, or small plates are inserted into the joints to hold them together while they heal. Patients with a history of failed bunion surgery may benefit from this procedure, as do those with a severe bunion or arthritis.
Exostectomy
Since it doesn’t aid in joint realignment and only removes the bump from the big toe, this procedure is rarely used to treat a bunion.
Even if Exostectomy is used in conjunction with other surgeries, such as the realignment of soft tissues, Exostectomy rarely helps correct the bunion or the underlying cause of the bunion.
It is not uncommon to perform an exostectomy as part of a bunion removal procedure that also includes osteotomy or soft tissue repair surgery. Exostectomy alone, i.e., without osteotomy or soft tissue realignment, increases the risk of recurrence of bunion deformity.
Arthroplasty After Resection
This procedure removes all of the diseased bone or joint from the patient’s body. As a result of this procedure, a flexible scar joint is created or expanded.
Patients over the age of 65, those with a history of bunion surgery complications, or those with severe arthritis that is not amenable to an arthrodesis are the primary candidates for this procedure.
In order to change the push-off or bend the big toe back in its correct position, this surgery or treatment procedure is most recommended by doctors.
At-Home Recuperation
There is no need to admit the patient to the hospital for bunion removal surgery, which means that the success of surgery and recovery is dependent in large part on how closely you adhere to your doctor’s instructions at home for a week following the procedure.
In addition, depending on the extent and type of surgery, you may be required to see your doctor on a regular basis for several months or even a year.
1. Taking Care of Yourself
You’ll be sent home with a bandage covering your toe until it heals properly, which is critical for proper healing.
You will be responsible for dressing your toe at home, and you must follow your doctor’s instructions exactly to avoid any complications. You should also avoid doing anything, such as changing anything, without consulting your doctor first, such as putting pressure on the toe.
The recurrence of the bunion can be caused by any interference in the healing process of your toe. Cover your foot with a plastic bag or sheet if you plan to take a shower so that the bandages and dressings around the wound are completely dry.
Your doctor will remove your suture two weeks after the surgery, but you will need to continue dressing your foot for up to six to twelve weeks in order for your toe to heal properly.
2. Prescription Medication
After surgery, you’ll be prescribed a variety of medications, the most important of which is pain medication to help you cope with the discomfort of the procedure. Opioids are the most effective painkillers.
If you’re prescribed opioids by your doctor, it’s critical that you follow his or her instructions and avoid overdosing. You should stop taking these medications as soon as they begin to ease your pain, and if that doesn’t work, talk to your doctor about it; they may prescribe you a different pain-reduction medication.
In addition to painkillers, your doctor may also prescribe you antibiotics to prevent any bacterial infection in your surgical wound.
3. Inflation
So keep your foot in an alleviated position as much as possible in the first week after the surgery, then apply ice to your foot as prescribed by the surgeon. This will reduce swelling and pain.
One thing to keep in mind is that you should never apply ice directly to your skin, and that the swelling on your foot may last for months or even years, so don’t freak out.
4. Weight-bearing
You and your doctor will discuss when you can put weight on your foot after surgery, and this will be determined by the specifics of your procedure.
Weight-bearing on an unhealed or unsupported foot can lead to complications such as bone shifts in the opposite direction, resulting in the bunion correction being rendered ineffective.
Bone healing requires a period of no weight bearing on the foot for the majority of bunion surgeries, while only a few allow patients to walk immediately after surgery with special surgical shoes designed to protect the bunion correction.
Crutches or knee walkers are two options that can be used to help with walking after bunion surgery because they prevent the foot from bearing any weight.
As an alternative to crutches, the knee walker is said to be an excellent choice because it has four wheels and is a type of scooter.
It includes a pad on which you must place the knee of your affected foot, and in order to propel the walker, you must push yourself with your other foot.
Your doctor may use bandages, a brace, or a cast to keep your foot in the proper position in a few instances.
Driving, excessive walking, and other daily activities that involve weight-bearing may all be out of the question (especially if the surgery is performed on your right foot).
Even if you had surgery for a bunion of one type or another, it is critical to follow your doctor’s instructions to the letter to avoid further complications. Don’t put any weight on your injured foot until your doctor tells you it’s safe to do so.
5. Exercise and Physical Therapy
There are a number of exercises you can do to help regain your foot’s strength and range of motion after surgery, in addition to medication and walking alternatives.
A therapist band or surgical band can be used for a few exercises to help restore ankle length, or marbles can be used to help with toe motion.
Start slowly and steadily with these exercises; do not overdo it, and follow your doctor’s or physical therapist’s instructions carefully.
6. Shoe Care
It may take a few months for your bunion to heal completely, and your doctor will give you some advice on what type of shoe to wear once it’s healed.
The best shoes for bunion correction are athletic shoes or oxford shoes with soft leather because they provide total comfort and don’t put too much pressure on your toes.
The best way to keep your bunion from returning is to avoid wearing any trendy shoes like high heels or pointed-toed shoes. In the most severe cases of bunion surgery, you will be unable to wear high-heeled shoes for the rest of your life.
Avoiding Complications
Even though complications following bunion surgery or at home during the recovery period are extremely rare, they are always a possibility. Be sure to call your doctor right away if any of the following occur:
If your clothing gets wet or loose, you should remove it.
If the dressing becomes wet or if blood drains from it, get medical help right away.
If you experience any side effects from your postoperative medications, please let us know.
Call your doctor immediately if you notice any of the following symptoms of an infection:
- If you have a fever that won’t go away.
I’m shivering. - If you notice a persistent redness or warmth around the dressing on your foot.
- If the pain worsens or persists, seek immediate medical attention, especially if it is similar to a sunburn.
- Swelling in the calf area of the affected foot, especially with a “charley horse” pain or breath shortening behind the knee, should be taken seriously.
Conclusion
One of the most common causes of bunion is wearing shoes that are too tight or pointing at the big or small toe joint, as well as any joint disease such as arthritis. If you have a severe case of bunions, it is best to have Bunion Removal Surgery to remove them.
Depending on the severity and type of your bunions, you may need surgery. Bunions can be effectively treated with surgery, and most people report a reduction in pain, swelling, and alignment of the big toe joint following the procedure.
Because of the variety of surgical procedures, the length of recovery time can vary greatly from patient to patient. It is imperative that you follow your doctor’s instructions and advice in order to avoid complications or recurrence of a bunion.
