If you have a bunion, you may be longing for a way to be free of that burdensome bump on the side of your foot. Bunions are unsightly, and they may or may not be painful. Bunion surgery is an option for some people, and it can correct damage, relieve pain and improve the appearance of your feet. Is bunion surgery right for you? Let’s find out.
Why Do You Want Bunion Surgery?
Surgery to correct bunions is not a cosmetic procedure. If you are not in pain, you are not a good candidate. For the majority of people with bunions, exercise, a change in footwear and smart use of padding and orthotics will take care of the problem. If these avenues are explored without success, surgery may be an option; however, it’s important to realize that sometimes surgery makes pain worse.
You are a good bunion surgery candidate if :
- Pain medications and anti-inflammatory medications don’t help.
- Your pain interferes with activities of daily living (ADL).
- You cannot exercise adequately because of your pain.
- Your big toe is trying to cross over your smaller toes.
- Your great toe is constantly swollen and inflamed.
- Your feet are never comfortable in any footwear.
- You are not able to bend or flex your big toe.
If any of these circumstances apply to you, your pain will probably be lessened by bunion surgery.
Understand What You Are Getting Into
If you’ve decided to approach your doctor about bunion surgery, be sure to ask the right questions, such as:
- How much does it hurt?
- How will pain be managed?
- What are the pros and cons?
- What are the complications?
- How frequent are complications?
Take notes so that you can review the information later and consider it in a pressure-free atmosphere. Consider your decision carefully and realistically. Understand that this surgery may necessitate some changes in your life. For example, you may need all-new shoes in a completely different style. No more pointy-toed cowboy boots or high heels!
Recovery can be lengthy and may involve physical therapy, exercise and follow-up doctor appointments for 6-12 months.
Understand Surgical Procedures for Bunion Treatment
There are several different surgical procedures to correct bunions. Discuss these with your doctor, and understand that minimal and simple procedures are not usually effective. Quick-fix bunion surgery is a band-aid solution that may ultimately worsen your condition.
Effective bunion surgery strives to realign the metatarsophalangeal (MTP) joint and the bones of the foot and repair the soft tissues of the big toe. Correction of this deformity should relieve your pain.
Common Types of Bunion Surgery
1. Exostectomy is one of the aforementioned “quick-fix” surgeries. It is not an especially effective procedure. It just removes the protrusion of the bunion without realignment of the bones or correction of soft tissue problems. This is basically a cosmetic procedure and is not usually permanent.
2. Tendon and ligament repair: Sometimes tendons and ligaments may be tight on one side of the toe and loose on the other side. This imbalance allows your great toe to drift toward, under or over your other toes. Tissue adjustments performed in conjunction with bone repair can correct this problem.
3. Osteotomy consists of small incisions in the bone that allow your surgeon to correctly align the MTP. Once it is realigned, the surgeon can affix it with plates, pins or screws. This process balances the joint and straightens the bones.
4. Arthrodesis is a procedure which involves removal of arthritic surfaces of the joint, after which plates, wires or screws are used to secure the joint until the bones have healed. This procedure realigns the entire foot and is often used when bunions are very severe or when other surgical procedures have failed.
5. Resection Arthroplasty is often recommended for elderly patients, those who have arthritis and/or those who have had unsuccessful bunion surgery. This procedure consists of removal of the damaged part of the MTP. The result is the creation of space between bones and a flexible scar joint. This procedure limits big-toe push-off power and can affect gait and ambulation.
All of these are typically considered out-patient procedures. On the day of your surgery, you can typically expect to spend several hours in the hospital or clinic. Be sure to arrange transportation for after, as you will not be fit to drive.
Getting Ready for Bunion Surgery
As with any surgery, you will surely need to see your general practitioner for a complete physical exam before going under the knife. This is a necessary step that can help identify potential problems and prevent complications.
When you go in for your physical, expect to:
1. Provide a list of all medications and supplements you may be taking.
2. Have your foot x-rayed in a standing, weight-bearing position.
3. Undergo procedures such as cardiogram and chest x-rays.
4. Give a complete medical history and family history.
5. Provide blood and urine samples.
Once you are cleared for surgery, your doctor and/or your surgeon will give you instructions regarding eating, drinking and taking medications or supplements prior to your procedure. Listen to and heed these instructions carefully.
Being Proactive Helps You Avoid Complications
Your doctor will also discuss possible complications with you. Understand that these are rare and that they can usually be treated and corrected. Some complications of the surgical procedure include infection and/or nerve injury. Complications that can arise following the procedure include:
1. Swelling and cramps in the lower leg.
2. Inflammation of the incision site.
3. Slow or no healing of the bone.
4. Failure of the wound dressing.
5. Pain in the back of the knee.
6. Continued or increased pain.
7. Persistent chills and fever.
8. Shortness of breath.
9. Bunion re-growth.
10. MTP stiffness.
If you experience these or any other problems, you should consult your doctor right away. Quick action can help prevent serious complications.
Follow Your Doctor’s Orders For Successful Recovery
Your recovery at home will involve responsible use of pain medications and mindful participation in exercise and physical therapy (PT). Be sure to follow your doctor’s advice carefully when taking pain killers (most likely opiods) to avoid drug dependence. If your doctor prescribes antibiotics to ward off infection, be sure to take the entire course of medication as directed. Do your home exercises regularly and attend your PT sessions without fail.
Take Care Of Your Healthy New Feet!
Good preparation, effective surgical technique and careful attention to detail during recovery can add up to complete success in bunion surgery. Once your rehabilitation is complete, be sure to protect your feet by wearing properly fitted, supportive shoes. Soft leather oxfords with little or no heel, athletic shoes and other comfortable footwear with a roomy toe box are advised. Stay away from constricting dress shoes and high heels as wearing these types of shoes can cause a recurrence of bunion problems.