Bunions

Definition

 What is a Bunion?

A bunion is a problem that can develop due to hallux valgus – a foot deformity. The term “hallux valgus” is Latin and means a turning outward (valgus) of the big toe (hallux). The bone that joins the big toe, the first metatarsal, becomes prominent on the inner border of the foot. This bump is the bunion and is made up of bone and soft tissue.

 What are the causes?

The majority of bunions are caused by the prolonged wearing of poorly fitting shoes, such as shoes with a narrow, pointed toe box that squeezes the toes into an unnatural position.

A study by the American Orthopaedic Foot and Ankle Society found that 88% of women in the U.S. wear shoes that are too small and 55% have bunions. Not surprisingly, bunions are nine times more common in women than men.

A small percentage of bunions can be attributed to heredity, arthritis or polio.

What is Bunion Surgery?

For many people with bunions, surgery is an appropriate option when non-surgical treatments have failed to provide adequate pain relief. Bunion surgery – generally referred to as a bunionectomy – is designed to remove the “bump” of the bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred. The goal of bunion surgery is to reduce pain, improve function and decrease deformity to enable the patient to resume normal activities.

Here are some reasons you may benefit from bunion surgery:
  • Severe foot pain that limits your everyday activities, including walking and wearing reasonable shoes. You may find it hard to walk more than a few blocks (even in athletic shoes) without significant pain.
  • Chronic big toe inflammation and swelling that doesn’t improve with rest or medications.
  • Toe deformity-a drifting in of your big toe toward the small toes.
  • Toe stiffness-inability to bend and straighten your toe.
  • Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. Their effectiveness in controlling toe pain varies greatly from person to person.
  • Failure to substantially improve with other treatments such as a change in shoes and anti-inflammatory medication.

Many studies have found that 85% to 90% of patients who undergo bunion surgery are satisfied with the results.

Various types of surgical procedures are available to treat bunions. In selecting the procedure, your surgeon has taken into consideration the extent of your bunion deformity based on x-ray findings, your age, your activity level, and other factors.

Types of Bunion Surgery

Surgeons use many different surgical procedures to treat bunions. The common goal of these procedures is to realign the joint, relieve pain, and correct deformity. These procedures include:

Repair of the Tendons and Ligaments Around the Big Toe

These tissues may be too tight on one side and too loose on the other, creating an imbalance that causes the big toe to drift toward the others. Often combined with an osteotomy, this procedure shortens the loose tissues and lengthens the tight ones.

Arthrodesis

Removal of the damaged joint surfaces, followed by the insertion of screws, wires, or plates to hold the surfaces together until it heals. Used for patients with severe bunions, severe arthritis, and when other procedures have failed.

Exostectomy

Removal of the bump on the toe joint; used only for an enlargement of the bone with no drifting of the big toe. This procedure is seldom used because it rarely corrects the cause of the bunion.

Resection Arthroplasty

Removal of the damaged portion of the joint, used mainly for patients who are older, have had previous bunion surgery, or have severe arthritis. This creates a flexible “scar” joint.

Osteotomy

The surgical cutting and realignment of the joint. Your surgeon will choose the procedure best suited to your condition.

If the problem persists, please call us to schedule an appointment.