Bunionectomy Surgery

By: Sarah Katsaras, MPT, OCS

What is a Bunion?

A bunion is a bony bump that forms at the base of the big toe and may result in the big toe drifting toward the second toe. Several things are thought to cause bunions, such as wearing narrow, tight-fitting shoes, pressure on your big toe joint from having a flat arch and some may even inherit the deformity from parents. Bunions can be unsightly, make shoes fit badly and can be very painful. 

Treating a Bunion

Bunions can be treated conservatively in several ways. The easiest way to relieve pressure on your bunion is to wear wider shoes such as athletic shoes to keep them from rubbing on the bunion and to give you better arch support. There are also pads that can be worn on the bunion for cushioning or in the shoe to support your arch. Another conservative option is to try physical therapy which can improve your pain, motion and foot strength. 

Bunionectomy SurgeryImage of bunionectomy surgery.


Bunionectomy Surgery 

Evidence shows that conservative intervention for bunions provides relief from symptoms but does not reverse the deformity. These non-surgical interventions include choosing shoe wear with a larger/wider toe box, various shoe orthoses to reduce stress on the big toe, and physical therapy. 

It has been proposed that an orthotic to improve arch support may improve the alignment of the first metatarsal, and therefore discourage progression of hallux valgus. Orthotics have been successful in the relief of pain associated with other conditions like plantar fasciitis and rheumatoid arthritis. 

Are you a candidate for bunionectomy surgery?

If conservative methods (such as those listed above) don’t work, then you may need surgery. 

Bunionectomy surgery is not typically done for cosmetic reasons and candidates for surgery usually have one or more of these symptoms: 

  • Foot pain that limits the ability to walk.
  • Chronic swelling/inflammation in the big toe.
  • An increasing deformity that limits the ability to function.
  • Increasing big toe stiffness that limits the ability to walk.

In general, the goals of bunionectomy surgery are to realign the MTP joint, relieve pain, and correct other bony deformities of the first ray (bones that make up the inside portion of the foot and toe). 

What is done in this surgery?

There are many different types of surgeries but the most common are the osteotomy and the arthrodesis. The osteotomy is done much more frequently and is the removal of bone and realignment of the joint. The arthrodesis is a fusion of the joint and is done to combat severe arthritis and pain. It is not done as often because it results in an inability to move the joint at the big toe. 

Bunionectomy surgery often includes repairing the soft tissues around the big toe as well, as they typically become too tight on one side and loose on the other side due to the malalignment.

How long is the recovery?

 The time to recover varies a lot, depending on which surgery is done, but you will most likely be on crutches or a walker for a couple weeks and then have a walking boot for up to 8 weeks. It usually takes 4 to 6 months to return to all normal activities including aerobic exercise.

If you want to schedule an appointment with JOI Rehab, you can call 858-7045. 


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