What is a bunion?
A bunion (hallux valgus) is an
enlargement of the joint at the base of the big toe. If you have a bunion, you
will notice a bump on your big toe joint. The big toe may turn in toward the
second toe (displacement), and the tissues surrounding the joint may be swollen
See a picture of a
What are the risks of bunions?
A bunion can
cause discomfort and pain and may make it difficult to walk. Shoes may rub on
the bunion, causing pain, blisters,
calluses, or sores. At the bunion location, a
bacterial infection of the skin (cellulitis) or
bone (osteomyelitis) may occur, especially if you have
peripheral arterial disease. If you have one of these
conditions and sores develop, contact your doctor.
of a bunion may be embarrassing for some people.
What are the types of bunion surgery?
over 100 surgeries for bunions. Research does not indicate which type of
surgery is best-surgery needs to be specific to your condition. More than one
procedure may be done at the same time.
The general types of
bunion surgery include:
- Removal of part of the metatarsal head (the
part of the foot that is bulging out). This procedure is called exostectomy or
- Realignment of the soft tissues (ligaments) around
the big toe joint.
- Removal of a small wedge of bone from the foot
(metatarsal osteotomy) or from the toe (phalangeal osteotomy) and moving the
bones into a more normal position.
- Removal of bone from the end of
the first metatarsal bone, which joins with the base of the big
toe (metatarsophalangeal joint). At the metatarsophalangeal joint, both the big
toe and metatarsal bones are reshaped (resection
- Fusion (arthrodesis) of the big toe
- Fusion of the joint where the metatarsal bone joins the
mid-foot (Lapidus procedure).
- Implant insertion of all or part of
an artificial joint.
What are the possible complications of bunion surgery?
Complications of surgery may include:
- Infection in the soft tissue or bone of the
- Side effects from
anesthetic medicines or other medicines used to
control pain and swelling.
- Recurrence of the bunion.
outward or upward bend in the big toe.
- Decreased feeling or
sensation, numbness or tingling, or burning in the toe from damage to
- Damage to the tendons that pull the big toe up or
- A shorter big toe, if bone is removed.
movement or stiffness of the big toe joint (may be an expected outcome of some
types of surgery).
- Persistent pain and
- Degenerative joint disease (arthritis) or avascular necrosis (disruption of the
blood supply to the bone) after surgery.
- Development of a
callus on the bottom of the foot.
Is bunion surgery effective?
of surgery for bunions has not been widely studied. It depends on the type of
surgery, the surgeon's experience, and the severity of the deformity. It also
depends on what you expect from surgery.
In a review of bunion
surgeries, 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 not
clear. Some reasons for being disappointed in the results of surgery could be
that 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 motion
compared to the other foot.1
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