A bunion is a foot deformity which affects the big toe. A bunion forms when the bone connecting the metatarsal and big toe begins to turn outwards. The bone juts out, and the big toe may start to drift towards the other toes. As a result, a bump made of bone and soft tissue called a bunion forms on the inner border of the foot. A bunion can be treated surgically, often with great success, but there is a long recovery period following surgery.
There are four different types of bunion surgery. The rarest type, exostectomy, simply removes the bump or bunion that has formed on the toe joint. This is not performed regularly because it does not correct the drifting of the toe. Arthrodesis is another procedure, which involves removing the damaged joint of the toe and inserting screws, plants or wires in its place. Arthroplasy involves removing damaged portions of the toe and realigning it. Finally, a simple surgery may be performed to repair tissue, which has stretched and become tight on one side and lose on the other to accommodate the bunion.
According to Your Orthopedic Connection, between 85 and 90 percent of people who undergo bunion surgery are satisfied with the reduction of pain as a result of the surgery. However, Your Orthopedic Connection cautions patients to keep expectations reasonable. The procedure is not cosmetic and will not allow you to wear certain shoes or change the appearance of your foot. The only purpose is to relieve pain.
The recovery period for bunion surgery can last between six weeks and six months, and in some cases take up to one full year for a complete recovery, depending on the extent of the bone and soft tissue affected by the surgery. Typically, stitches in the foot are removed between seven and 21 days after surgery. If pins were installed to keep the toe in place, those are usually removed between three and six weeks after the surgery. Special surgical shoes are usually worn for at least four weeks after surgery, and often for up to 12 weeks after surgery. Most normal activities can be resumed six to eight weeks after surgery, but typically the foot can't bear any weight for at least six to eight weeks, and may only be able to bear partial weight for several additional weeks. A wheelchair, walker, cane, and/or special shoes may be recommended during this time.
The foot will be bandaged for at least the first seven to 21 days while the stitches are present. It is essential to keep the bandage dry during that time. It is also essential to wear special shoes as recommended by your doctor, during that time and throughout the recovery process. Walkers, canes or crutches should be used until the doctor informs you it is appropriate to put weight on the foot, and you should gradually build up to walking longer distances. During the first few days after surgery, it is best to keep the foot elevated and use ice to manage pain and swelling. Swelling can linger for up to six months. Physical therapy, exercise and the use of a surgical band may be recommended to strengthen the toe after surgery.
Long-term risks of surgery include reduced flexibility of the tendon, and in some rare cases nerve damage which causes persistent, lingering pain in the toe. The big toe may never recover full motion, and you may never be able to wear certain types of narrow or high heeled shoes.