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Bunion Removal
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Bunion Removal

(Hallux Valgus Repair)

En Español (Spanish Version)

Definition

Repair of a deformity in the joint that connects the big toe to the foot.

A bunion is an inflammation and enlargement of the big toe's joint and the sac around the joint. In some cases the deformity is so severe that the big toe begins to slant towards the outside of the foot, a condition called hallux valgus.

Bunion

Bunion

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Parts of the Body Involved

  • Bone
  • Joints
  • Tissue of the big toe and foot

Reasons for Procedure

  • Other attempts at therapy have failed, such as anti-inflammatory agents, physical therapy, specially shaped shoes, or inserts to decrease pressure on the bunion
  • The pain of a bunion interferes with walking
  • The foot deformity (hallux valgus) makes walking difficult

It is important to have realistic expectations before having a bunion removed. Complication and recurrence rates can be high.

Risk Factors for Complications During the Procedure

  • Smoking
  • Alcoholism
  • Diabetes
  • Poor nutrition
  • Chronic illness or general debilitation

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam, especially of your foot
  • Foot x-rays

In the days leading up to your procedure:

  • Arrange for a ride to and from the procedure
  • Arrange for help at home after the procedure
  • The night before, eat a light meal, and do not eat or drink anything after midnight
  • You may be asked to shower the morning of your procedure, and you may be given special antibacterial soap to use

During Procedure

Sedation, anesthesia

Anesthesia

Local or general, depending on the complexity of the surgery

Description of the Procedure

There are several types of bunion removal procedures. Generally, the surgeon cuts into the foot near the bunion, and the excess growth of bone is removed with a bone saw. Depending on the degree of deformity, the surgeon may need to cut into the bone of the toe and realign the bones so that the toe no longer slants to the outside. Other revisions may be necessary as well. Improving the angle of the toe and repairing these bones may require a metal pin, screw, or rod to hold them in place. The incisions are closed with stitches, and a bulky bandage is applied.

After Procedure

Your foot will be bandaged, and you'll be given instructions about whether or not you may bear weight. To keep the swelling down, you should ice your foot and keep it propped up on pillows for several days.

How Long Will It Take?

Depending on how extensive the repair needs to be, anywhere from less than 30 minutes to over 2 hours

Will It Hurt?

Anesthesia prevents pain during the surgery. You will have pain after the surgery, though, and you'll be given medication to help.

Possible Complications

  • Swelling
  • Infection
  • Bleeding
  • Your toe may be misaligned or too short
  • The bunion may recur

Average Hospital Stay

0-1 day

Postoperative Care

  • Your foot will be bandaged and you may need to wear a special postoperative shoe for several weeks
  • Depending on how extensive your operation was, you may need to wear a splint or cast, and you may need to use crutches or a walker for a brief time
  • After your foot has healed sufficiently, your doctor will recommend specific exercises or physical therapy to help you regain strength, flexibility, and stamina
  • Discuss with your doctor the kind of footwear you should use, and how to make sure that it fits correctly
  • If your surgeon uses certain types of pins to stabilize the repair, you'll need to have these removed several weeks after your operation

Outcome

Bunion removal may ultimately result in better mobility with less pain. You may notice that your foot is narrower without the bunion. Initial stiffness in the joint can be improved with special exercises or physical therapy that your doctor can recommend. It may take as long as eight weeks after bunion surgery for your foot to be well healed.

Call Your Doctor If Any of the Following Occurs

  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Nausea and/or vomiting that you can't control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
  • Signs of infection, including fever and chills
  • Pain that you can't control with the medications you've been given
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting

RESOURCES:

American Academy of Orthopedic Surgeons
http://www.aaos.org

American Podiatric Medical Association
http://www.apma.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

Podiatrists in Canada
http://www.footdoctors.ca/

References:

American College of Foot and Ankle Surgeons

Ferrari J. Higgins JP. Prior TD. Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database of Systematic Reviews . (1):CD000964, 2004.

Wexler D, Kile TA. Frontera: Essentials of Physical Medicine and Rehabilitation . 1st ed. Philadelphia; Hanley and Belfus; 2002. Ch. 79.



Last reviewed December 2007 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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