While mostly harmless, bunions can progress to the point where they cause significant foot pain and mobility issues. When your bunion pain prevents you from doing the things you love or completing your normal daily activities, you may need surgery to correct the issue.
Remind me – what’s a bunion again?
A bunion is a foot condition that develops when you develop bony growths on the outside of the joint where your big toe joins the rest of your foot. Often this growth causes your big toe to turn toward the rest of your toes while the bony hump grows on the edge of your foot.
In addition to the deformation of the big toe and its joint with the foot, bunions present other symptoms including inflammation and swelling, skin irritation, pain and mobility problems. Bunions develop when your big toe moves out of place. This is often due to genetics and poor foot structure although wearing improperly fitting shoes or high heels can also contribute to the condition.
In most cases, bunions can be treated conservatively with a change in footwear, orthotics and toe spacers. However, if the misalignment and deformity is too great, surgery may be the best option to get rid of the bunion.
Why would I need bunion surgery?
Bunion surgery is used when other more conservative treatment methods have failed and your bunions are getting in the way of your normal activities by causing severe pain and mobility issues. Fortunately, there are many different procedures available and many can be performed in both traditional and minimally invasive techniques.
What are the different kinds of bunion surgery available?
There are several procedures that can be used to correct bunions, ranging from minimally invasive techniques to release tension in the ligaments and soft tissues to more invasive procedures where the surgeon removes part of the bones and surgically realigns the bones.
Osteotomy, for example, is a procedure where your surgeon will make small cuts in your bones to create space to reposition them in the correct alignment. He may use pins to hold the bones in the corrected position while you heal.
Exostectomy is a procedure where the surgeon removes the bony growth that makes up the recognizable hump of your bunion is shaved away. Exostectomy is frequently used with additional procedures like an osteotomy to correct the alignment of the toe.
During resection arthroplasty, your surgeon actually removes the damaged parts of your joint, which creates extra space for the metatarsals to be realigned with a flexible ‘scar’ joint.
What’s the difference between minimally invasive surgery and traditional surgery?
During a traditional surgery, the surgeon opens up your skin to access the bones, tendons and ligaments in your foot, while in a minimally invasive surgery he will make small key hole incisions and use specially designed instruments, often involving arthroscopy or fluoroscopy to see inside your foot and the joints without having to make a larger incision.
Arthroscopy uses a miniscule camera on the tip of a tube which is inserted into the foot while fluoroscopy uses x-rays to show the doctor the inside of your foot.
In many cases, it's recommended to have minimally invasive surgery because of the benefits associated with the smaller incisions. There's a reduced risk of infection, the bunion surgery takes less time, and recovery is usually quicker. There is a reduced risk of bleeding and no visible scarring.
So does that mean that minimally invasive surgery is best?
In most cases, yes. However, some of these bunion surgeries are more effectively performed with a traditional open surgery. The correct realignment of your bones is a precise procedure and it may be necessary to use a traditional approach to guarantee the best possible outcome of your surgery.
How do I know which surgery is best for me?
You can count on Dr. Nagy and his expert staff at Nagy Footcare to provide you with the best possible advice about how to treat your bunions. The will try a conservative approach in most cases, but if surgery is the best and most effective way to get you back on your feet, they will provide a thorough consultation so you understand the risks and benefits of all your treatment options.
If your bunions are preventing you from doing what you want, make an appointment with a New Hampshire podiatrist at Nagy Footcare for compassionate and expert care.