Should I have surgery for bunions?

posted on 19 Mar 2014 05:00 by tightidol5048

Should I have surgery for bunions?

What is a bunion?
A bunion (hallux valgus) is anenlargement of the joint at the base of the big toe. If you have a bunion, youwill notice a bump on your big toe joint. The big toe may turn in toward thesecond toe (displacement), and the tissues surrounding the joint may be swollenand tender.

See a picture of abunion .

What are the risks of bunions?
A bunion cancause discomfort and pain and may make it difficult to walk. Shoes may rub onthe bunion, causing pain, blisters,calluses, or sores. At the bunion location, abacterial infection of the skin (cellulitis) orbone (osteomyelitis) may occur, especially if you havediabetes orperipheral arterial disease. If you have one of theseconditions and sores develop, contact your doctor.

The appearanceof a bunion may be embarrassing for some people.

What are the types of bunion surgery?
There areover 100 surgeries for bunions. Research does not indicate which type ofsurgery is best-surgery needs to be specific to your condition. More than oneprocedure may be done at the same time.

The general types ofbunion surgery include:
Removal of part of the metatarsal head (thepart of the foot that is bulging out). This procedure is called exostectomy orbunionectomy.Realignment of the soft tissues (ligaments) aroundthe big toe joint.Removal of a small wedge of bone from the foot(metatarsal osteotomy) or from the toe (phalangeal osteotomy) and moving thebones into a more normal position.Removal of bone from the end ofthe first metatarsalbone, which joins with the base of the bigtoe (metatarsophalangeal joint). At the metatarsophalangeal joint, both the bigtoe and metatarsal bones are reshaped (resectionarthroplasty).Fusion (arthrodesis) of the big toejoint.Fusion of the joint where the metatarsal bone joins themid-foot (Lapidus procedure).Implant insertion of all or part ofan artificial joint.
What are the possible complications of bunion surgery?
Complications of surgery may include:
Infection in the soft tissue or bone of thefoot.Side effects fromanesthetic medicines or other medicines used tocontrol pain and swelling.Recurrence of the bunion.Anoutward or upward bend in the big toe.Decreased feeling orsensation, numbness or tingling, or burning in the toe from damage tonerves.Damage to the tendons that pull the big toe up ordown.A shorter big toe, if bone is removed.Restrictedmovement or stiffness of the big toe joint (may be an expected outcome of sometypes of surgery).Persistent pain andswelling.Degenerative joint disease (arthritis) or avascular necrosis (disruption of theblood supply to the bone) after surgery.Development of acallus on the bottom of the foot.
Is bunion surgery effective?
The effectivenessof surgery for bunions has not been widely studied. It depends on the type ofsurgery, the surgeon's experience, and the severity of the deformity. It alsodepends on what you expect from surgery.

In a review of bunionsurgeries, up to 33% of people who had surgery were disappointed in the result,despite the pain being less and the toe being straighter. The reasons are notclear. Some reasons for being disappointed in the results of surgery could bethat a person is not able to wear some types of shoes (such as high heels)after surgery, or that the joint is more stiff and has a little less motioncompared to the other foot.1

If you need more information, see the topicBunions.