A bunion — or hallux valgus, as the condition is clinically known — is a common foot deformity in which pressure and friction cause fleshy tissue to input at the base of your big toe and create a bony bump. For many people, surgery is the only option, since they can be painful and disrupt daily life. Depending on the severity of a bunion, there are several different types of bunion surgery, each of which is tailored to the individual patient’s needs. Here’s a guide to the various types of surgical procedures available to correct bunions, and what each entails.
When Do Bunions Require Surgery? This Explains
Bunions form as a result of genetics, poorly-fitting shoes, arthritis, or foot structure disorders. Mild bunions can often be controlled through orthotics, proper footwear and physical therapy, but surgery is needed when pain and discomfort remain despite conservative treatment.
Types of Bunion Surgery
Osteotomy
The most common surgery for bunions is called osteotomy. This includes cutting and repositioning the bones to fix the deformity. There are several types of osteotomy procedures:
- Chevron Osteotomy: most commonly used procedure for mild to moderate bunions. The surgeon creates a V-shaped incision on the metatarsal bone and repositions them to realign the bone structure.
- Scarf Osteotomy: Suitable for moderate to severe bunions. A long Z cut is made in the metatarsal bone, which allows for more realignment.
- Ludloff Osteotomy: Ludloff Osteotomy Determine oblique cut of the cutting bone fixed with screws
Exostectomy (Bunionectomy)
Exostectomy (simple bunionectomy) — The surgeon removes the bony bump on the side of the foot. This procedure is invariably done with other procedures, as it does not address the underlying misalignment.
Arthrodesis
Arthrodesis, or joint fusion, is a procedure used for the more severe forms of bunions, especially those related to arthritis. The surgeon cleans up the afflicted joint and fuses the bones together with screws or plates. This stops joint movement, alleviating pain and preventing additional deformity.
Lapidus Procedure
The most common representative is the Lapidus procedure, an arthrodesis of the first metatarsal with the medial cuneiform. It works well for hypermobile patients or severe bunions. It helps hold the joint steady to avoid recurrence and offers long-term correction.
Bunion Surgery, Minimally Invasive
Minimally invasive bunion surgery uses small incisions and specialized instruments to realign the bones without significant trauma to surrounding tissue. The advantages of this approach are
- Reduced post-operative pain
- Faster recovery
- Smaller scars
- Lower risk of complications
This technique is most appropriate for mild to moderate bunions.
Keller Bunionectomy
Keller bunionectomy Removing a portion of the base of the big toe joint. It is usually reserved for older patients whose arthritis is so advanced that they are not a candidate for other bunion correction surgeries.
Repair with Tendon or Ligament Balancing
Bunions can also form as a result of muscle and tendon imbalance. The surgeon then arranges the soft tissues around the prominent area to realign them. This procedure is frequently combined with osteotomy or bunionectomy.
Recovery and Care After Surgery
Bunion surgery recovery is dependent on the type of surgical procedure performed. Here are a few general rules of thumb:
- 0-2 Weeks After Your Surgery: Initial Recovery Patients are usually swollen, in pain, and have limited mobility. Weight off the foot is paramount.
- Mid-Recovery (2-6 weeks): Patients switch to a walking boot and may start some mild physical therapy.
- Full Recovery (6-12 weeks and beyond): Most patients return to all normal activities, but it may take a year for full healing.
Tips for a Smooth Recovery:
- Adhere to post-surgical procedures diligently.
- Avoid weight bearing as per instructions.
- You can use ice packs to help reduce swelling.
- Wear shoe gear to prevent reoccurrence.
- Keep all appointments for follow-up care.
Risks and Considerations
As with any surgical procedure, bunion surgery has some risks, including:
- Infection
- Blood clots
- Nerve damage
- Recurrence of the bunion
- Reduced range of motion in the joint
Selecting an experienced foot surgeon and following instructions for post-operative care can reduce these risks.
Conclusion
Depending on the severity of the bunion, the composition of your foot. And your overall health, there are several different types of bunion surgery that may be performed. If you suffer from a mild, moderate, or severe bunion, a foot and ankle surgeon will help evaluate the best surgical alternative for your individual needs. Knowing what these procedures entail will help you decide if it is a good fit for your foot health and recovery.
