...not the same painful surgery grandma had.
Technology and bunion surgery has changed quite a bit in the last 5-10 years. Pasadena Orthopedics offers minimally invasive procedures that allow you to get back on your feet as soon as a few days.
Also called hallux valgus, or hallux abductovalgus, a bunion is an enlargement of bone and/or soft tissue around the first metatarsal phalangeal joint. The bone that joins the big toe with the first metatarsal bone thickens and enlarges, tightening the tendons, which in turn causes the base of the big toe to angle out resulting in a painful bony deformity.
What causes a bunion?
A common cause of a bunion is prolonged wearing of ill-fitting or flexible footwear that compress the toes into unnatural positions and lack proper support. This can include high heeled shoes, narrow shoes, shoes that are too small or pointy shoes with a narrow toe box. Genetics which determine our foot type and certain disease conditions such as arthritis or polio also increase the risk of developing a bunion.
Bunions are much more prevalent in women than men, which may be associated with the use of heels or non supportive shoes.
Signs and symptoms
The signs and symptoms associated with bunions are as follows:
Pain with ambulation when wearing shoes
Swelling with red, calloused skin at the base of the big toe
Decreased mobility in the big toe
Inward turning of the big toe toward the second toe
Bulging of a bony bump at the base of the big toe
Formation of corns and calluses at the overlapping of the big toe and second toe
Diagnosis
The diagnosis of a bunion by an podiatric surgeon includes taking a medical history, and performing a physical and biomechanical examination to assess the extent of misalignment and damage to the soft tissues. Your doctor will order X-rays to help determine the extent of damage and deformity of the joints, as well as plan for surgery.
Treatment
Your surgeon initially will recommend conservative treatment measures with the goal of reducing or eliminating foot pain.
Such measures include wearing properly fitted supportive shoes with custom or over-the-counter shoe inserts, padding, or taping of bunions. Physical therapy and certain medications may be prescribed for relieving pain and inflammation.
If conservative measures fail to treat the bunion pain, then your surgeon may recommend a surgical procedure to address the bunion.
There are many surgical options to treat a bunion but the common goal is to realign the joint, correct the deformity, and to relieve pain and discomfort.
Bunion surgery entails surgical cutting and realignment of the joint. The podiatric surgeon selects the appropriate surgical procedure based on the patient's presentation and severity of the bunion.
This before & after x-ray below is of the Lapiplasty Procedure which uses small linear plates- however there are many different types of bunion procedures. This is another type of bunion procedure performed.
This is another type of bunion procedure performed below:
Risks and complications
As with any surgery, complications can occur. Complications after bunion surgery are rare with a board certified surgeon with experience. However, risks include:
Infection
Recurrence of the bunion
Nerve damage
Unresolved pain
Non-union or mal-union
Painful scar
In rare cases, a second surgery may be necessary to correct the problem.
Post-operative care
Patients should follow all instructions given by their surgeon. Common post-operative instruction includes:
Ask your surgeon if you will be getting a nerve block, which will help cut down on narcotic pain medication post-operatively.
Keep your dressing dry and in place until your follow up appointment- usually 2 weeks after your procedure.
Avoid bearing weight on the foot by using crunches or knee scooter for 4-6 weeks
Elevate the foot above heart level to minimize swelling.
Exercise and physical therapy may be prescribed for strengthening and restoring range of motion to the foot once you are able to ambulate.
Eat a healthy diet and quit smoking to facilitate healing.
Conclusion
A bunion is an enlargement of bone or soft tissues around the first metatarsal phalangeal joint. Bunions result in pain and impaired movement of the foot, making it difficult to find properly fitting shoes. If conservative treatment measures are unsuccessful, surgery is an option to consider.
Make an appointment with Dr. Sara Shirazi to discuss further!
(626) 517-0022
