A bunion is a painful bony bump that develops at the big toe joint. They develop slowly in response to pressure on the big toe joint, and are medically known as hallux valgus. In the long term, the structure of the bone changes, resulting in a bunion bump that may gradually increase in size, and make it painful to wear shoes or walk. Bunions occur more commonly in women, due to tight, narrow shoes that squeeze the toes together and make it more likely for bunions to develop. Bunion surgery is performed in order to correct bunions and bring the big toe back to its correct position, and may involve realignment of bone, ligaments, tendons, and nerves.
Who is a candidate?
Candidates for bunion surgery have significant foot pain that limits their everyday activities, including walking and wearing comfortable shoes. Their big toe may be chronically inflamed and swollen, and may have toe deformity, toe stiffness, and continued failure to relieve pain even after using over-the-counter medication and changing to more ergonomic footwear.
Who is not a candidate?
Candidates whose bunions do not cause pain or whose pain responds to traditional treatment of change in footwear and pain reliever medication should not consider bunion surgery, as surgery can still lead to pain postoperative, and may result in more complications.
Like other surgeries, bunions requiring surgery must first be diagnosed during a physical examination, with a discussion of both surgical and nonsurgical treatment options. You may need X-rays of your foot to more clearly see the deformity. You should inform your orthopedic surgeon of any medications or supplements you take, and comply with certain general surgery protocol such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior. You will likely be asked to stop eating or drinking the night before the surgery.
Immediately after your procedure, you will need to follow postoperative instructions on caring for the wound dressing, and likely will be prescribed pain medication for any pain or discomfort. Keep your foot elevated as much as possible in the first few days postoperative in order to minimize swelling. You will likely require a period of no weight-bearing on the affected foot, and may need to restrict driving. Physical therapy will help restore strength and range of motion. Full recovery will take several months, but light normal activities can resume a few weeks after surgery.
As with any surgery, there are risks of complications related to infection, damage to nerves and blood vessels, bleeding and blood clots, or adverse reactions to anesthesia. Risks specific to bunion surgery include failure to relieve pain, failure of the bone to fully heal, recurrence of the bunion, and stiffness of the big toe joint.
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