A bunion (medically called Hallux Valgus) is a bone deformity in the base of the first finger of the foot or first metatarsal (please click the link for more information on foot surgery). Many people develop bunions through their lives due to the excessive use of certain type of shoes (like pointed or very tight shoes, high heels), genetic reasons, among others.
In fact, according to a study called “Prevalence of hallux valgus in the general population: a systematic review and meta-analysis”, approximately 23% of people between 18 and 65 years old and 35,7% of people older than 65 years of age, have a bunion. This problem is usually more common among women, which can be explained by the type of shoes they wear.
In many cases, using shoes that fit well, adding pads to the shoes, and taking certain painkillers can help to relieve the pain. However, in other cases, the patient still feels pain after all these measures, so the doctor can recommend correcting the bunion through surgery.
WHAT IS A BUNION SURGERY?
A bunion surgery, or bunionectomy, can be defined as the surgical procedure performed to correct the deformity in the head of the first metatarsal. This procedure is reserved for those patients that don't feel pain relief with traditional and non-surgical treatments.
The surgeon must choose among different types of surgeries to correct the bunion in the best possible way. According to the patient's conditions, the surgeon may need to correct the bone alignment and damages in the ligaments, tendons and even some nerves.
WHO SHOULD CONSIDER BUNION SURGERY?
A bunion surgery is usually recommended for those patients who can't delay the bunion progression or can't relieve the pain with traditional treatments. In fact, surgeons usually reserve the surgery for patients who have severe pain that limits their everyday activities (like walking) even in athletic or anatomical shoes, chronic inflammation and swelling in the big toe, inability to move the big toe and persistence of the pain after taking nonsteroidal anti-inflammatory drugs (NSAIDs).
The patient must understand that this is not a cosmetic procedure but a medical one.
HOW IS A BUNION SURGERY PERFORMED?
According to Orthoinfo, during a bunion surgery, the surgeon starts with a small incision in the side or top of the first metatarsal to, in the first place, realign the articulation and correct any deformity in the bone, which is the main problem of the Hallux Valgus.
The specific method will depend on the type and size of the bunion, but in most cases, the surgeon must also repair the soft tissues around the bone. For example, the surgeon can use some wires, screws or plates to reshape the articulation and after that, he/she makes some stitches in any damaged ligament or muscle to bring more support to the new articulation shape.
HOW LONG DOES A BUNION SURGERY LAST?
The surgical time of a bunion surgery depends on the degree of misalignment in the metatarsophalangeal joint and the presence of damages in the surrounding soft tissues. Every bunion surgery is different, so only a qualified surgeon can approximately determine the surgical time that it will take and there is no reason to be concerned if the surgery is taking more time than expected.
However, a bunion surgery can take between 30 and 45 minutes average to be completed. But, if prior preparation and recovery process are included the surgery usually lasts 90 minutes.
HOW TO TAKE PROPER CARE AFTER A BUNION SURGERY?
The proper care after a bunion surgery can vary among patients according to the need of bone healing or not, and the changes that the surgeon had to perform during the procedure.
When the patient requires bone healing, as in most cases, the bone may need approximately 6 weeks to heal, even a little longer sometimes. However, experts say that the full recovery after a bunion surgery can require up to 6 months.
Experts usually recommend using a post-op or bunion shoe for one week after the procedure, but in the more complicated cases, the surgeon may recommend using this special shoe for 5 weeks or using crutches to walk.
Likewise, some patients are allowed to walk immediately after the surgery, while others must wait for a short period of time before applying weight on the foot.
HOW LONG SHOULD I BE OFF WORK AFTER A BUNION SURGERY?
The time that a patient should be off work after a bunion surgery will vary according to the type of surgery that was performed and the type of work that the patient has. For example, patients that must be 8 hours or more on their feet, may need to take more time than people who work in a sitting position.
HOW MUCH DOES A BUNION SURGERY COST?
A bunion surgery is usually an easy surgical procedure; however, the cost will depend on the difficulty to perform the procedure, the need for subsequent treatments, the patient's general health condition, the x-ray for the bunion before and after among others.