Bunion correction surgery
Bunion correction is surgery used to treat a bunion that has formed on the big or little toe. A bunion is a bump at the toe joint which may cause misalignment of the toe. The bump represents abnormal bone or tissue formation, sometimes resulting from rheumatoid arthritis of the foot and ankle. The misalignment can cause the toe to move outward and cross over the adjacent toe. This also results in inflammation, swelling and pain in the joint of the affected toe. The big toe is the one most commonly affected by bunions. The goal of bunion correction surgery is to relieve pain and correct deformity.
Bunions most commonly affect women and can result from tight-fitting or narrow shoes or high heels. Abnormal formation in the toes at birth also can cause bunion growth. Disease such as rheumatoid arthritis can cause bunion growth as it progresses and deforms the bones of the foot. Other nerve conditions and injuries are known causes for bunion growth. Bunions are also common in ballet dancers. It can be said that bunions are formed due to strain, restriction or improper movement of the foot.
Most bunions can be treated without surgery by using nonsurgical treatments such as:
- Rest – Avoiding excessive walking and exercise can help to correct the inflammation at the bunion and relieve pain.
- Change in footwear – In cases where the bunion is a direct result of restrictive foot wear, avoiding shoes that push the toes together and wearing sandals can relieve pressure and pain from the bunion. For women who wear high heels, changing to a flat shoe with arch support can help tremendously. Custom insoles also can add support and decrease pressure on the bunion.
- Anti-inflammatory medicine – Aspirin, ibuprofen and naproxen are the most common over-the-counter medications use to control the inflammation, swelling and pain in the affected toe. These can be used in combination with ice or heat therapy to further control the painful symptoms of a bunion.
- Stretching exercise – These are sometimes prescribed by your doctor to relieve tension on the inner part of the bunion. Stretching can increase blood flow to the area and help the surrounding tissues to function properly.
- Bunion splint – This orthotic device can be worn at night to further relieve the symptoms of a bunion.
- Cortisone injections – This steroidal injection can sometimes reduce inflammation in the base of the toe.
The type of surgical procedure performed for bunion correction mostly depends on the severity of the bunion and the condition of the bones and connective tissue. Types of bunion correction surgery include:
- Tendon and ligament repair – When these tissues are too tight on one side and too loose on the other side of the affected toe, it creates an imbalance which causes the big toe to drift toward the others. This procedure shortens the loose tendons and lengthens the tight ones.
- Athrodesis – This procedure consists of removing the damaged joint surfaces, then inserting screws, wires and/or plates to hold the surfaces together as they heal. This procedure is normally used in cases of severe and arthritic bunions.
- Exostectomy – Includes removal of the abnormal bump on the toe joint and is used only in cases that include enlargement of the bone without drifting of the big toe. This is not a commonly used bunion correction procedure because it does not correct the underlying cause of the bunion.
- Resection arthroplasty – This procedure is used mainly for older patients and those with severe arthritis or who have had previous bunion correction surgery. The procedure includes removal of the damaged portion of the joint.
- Osteotomy – This surgical procedure consists of the cutting and realignment of the joint.
- Joint reconstruction or replacement – If the joint is damaged beyond repair it may need to be reconstructed or completely replaced with an artificial joint. Joint replacement implants may be used in the reconstruction of the big toe joint.
The multidisciplinary team of foot and ankle experts at Northwell Health Orthopaedic Institute can perform bunion correction as well as a broad range of surgeries for conditions that affect the foot and ankle.