A bunion, known medically as hallux valgus, is a very common foot problem that's often a source of recurring pain. Even when a bunion is not acutely painful, it can make wearing shoes uncomfortable when the bump on the side of the foot presses against the shoe. The bump is the result of changes to the metatarsophalangeal (MTP) joint, one of the five joints that flex and extend the toes. A bunion usually occurs at the first MTP, also known as the big toe joint. A bunionette, or tailor's bunion, occurs at the 5th MTP joint on the little-toe side of the foot.
- Image Gallery: Photos of Different Types of Bunions
The discomfort caused by a bunion can be managed with non-surgical treatments, but these methods won't correct the actual bunion. Bone and soft tissue changes, including a change in position of the metatarsal bone and resulting joint damage, can all occur with a bunion. When conservative treatment methods fail, many bunion sufferers consider surgical correction.
- More about bunion symptoms and non-surgical treatment of bunions: Symptoms, Causes, and Treatment for Bunions
- Also recommended: 5 Tips for Soothing Bunion Pain
If you are considering surgery, a consultation with a foot specialist can help you decide if bunion surgery is right for you. A visit with a podiatrist will involve an evaluation of your medical history and a detailed examination of your feet to determine the cause of the bunion, as well as the degree of the deformity. The doctor will assess whether surgery is an option, and if so, will discuss the details of how the bunion will be corrected, and what to expect after the surgery.
The doctor will evaluate X-rays of your feet, which are used in planning the best surgical method for correcting the bunion. Factors that may be taken into consideration include:
- Your foot type and foot function, including whether you are an over-pronator
- The condition of the MTP joint and degree to which the toe has shifted out of place
- An assessment of other deformities that may have developed along with the bunion, such as a hammer toe
In most cases, bunion surgery will involve an osteotomy, which is a surgical cut to the bone. A bunion is usually the result of problems with the size or position of the metatarsal bone, so the purpose of an osteotomy is to re-size or reposition the metatarsal, and possibly the phalangeal (toe) bone, into a better anatomical position. The type of osteotomy used may also factor into post-op recovery; for example, it may affect how long a person will have to be non-weight bearing after the surgery. The bump on the side of the bone, which gives a bunion its characteristic look, will be removed if necessary.
Besides correction of bone abnormalities, bunion surgery may also involve repositioning of tendons, or tightening joint ligaments to help stabilize that area of the foot. Surgical screws or pins will be used to protect the osteotomy site and stabilize it as it heals. Keeping the foot stable while it heals after the surgery is extremely important to successful healing. Bunion surgery patients will need to follow the post-op orders on caring for the foot after surgery, being careful to avoid weight-bearing until the doctor says it's O.K. The surgery may involve a period of non-weight bearing, which is generally 2-6 weeks.
In the weeks following the surgery, there will be a few post-op visits to the doctor. At these visits, the surgical site will be checked for adequate healing, and new bandages will be applied. These follow-up visits are important for ensuring that the surgical site is healing well and staying clear of infection or other complications. After a period of time, your doctor will decide when to remove a cast or allow weight-bearing without a velcro surgical shoe. Sometimes patients are prescribed physical therapy after a period of healing. This is often aimed at helping to maintain range-of-motion of the big toe.