Is Bunion Surgery Worth It?
Bunions are one of the most common foot problems, making bunion removal surgery a real option for many. A bunion, also known as hallux valgus, is a bony bump forming at the joint of the big toe; they are often inflamed and painful. A person suffering from this kind of problem can experience pain that can range from barely noticeable to severe and unable to walk. In some worst cases, bunion surgery is the solution to alleviate pain and pressure. Whether or not bunion surgery is worth it to you in terms of time, discomfort and money depends upon many factors.
Our feet consist of toes, and one toe is made up of two joints. The biggest one is the metatarsophalangeal joint or also known as the MTP; this where the first long bone of the foot (metatarsal) and the first long bone of the big toe (phalanx) meet. The MTP joints are the usual target points affected by the bunion.
Bunions occur when the MTP bones are misaligned. This happens when the metatarsal goes in from the base and phalanx shifts towards the other toes; the MTP joint grows more significant from the inside and makes it look like it popped out. The primary cause for this foot deformity is tight shoes, especially in the toe area. It can also be inherited or a product of an inflammatory condition, like arthritis.
These problems start small and grow larger over time. If bunions are not treated, the consequences may be severe and permanent.
Conversely, bunions are more common in women than in men; this is because the majority of women’s footwear is tight and is uncomfortable in the toe area.
What is bunion surgery?
Bunion surgery, or bunionectomy, is a medical procedure that corrects the deformity and relieves or reduces pain caused by bunions. Bunion surgery is not a cosmetic procedure. Although part of it is to correct the deformed area, its goal is to ease the pain and pressure, fix the joint in the toe, and realign the foot’s structure. It also prevents another bunion from forming in the future.
Should you get bunion surgery?
Bunions are an extremely difficult foot condition. Ultimately, severe pain and deformity will determine if you qualify to get a bunion surgery or not. Today, there are minimally invasive bunion procedures that may make it more likely you can successfully have this procedure. There are some specific instances or reasons that can guide you in seeing if you need bunion surgery.
- Home remedies and pain preventing measures won’t work.
- The pain is intolerable that it prevents you from doing mundane tasks.
- There is much difficulty walking even short distances.
- Pain and swelling persist even after rest and medication.
- You are unable to move your big toe. You cannot straighten or bend it because of pain or stiffness.
- Paint continues even when wearing reasonably comfortable shoes.
- Severe deformity of toes that the big toe crosses and overlaps the other toes.
- The foot is too deformed to fit into shoes
- Asking a medical professional would be the best way to go to know how bad your bunion is.
Types of Bunion Removal Surgery
There are more or less 100 different kinds of bunion surgeries. The operation will depend on the situation, how it developed, and the current size.
Tendon and Ligament Repairs Around the Big Toe
In some cases, the cause of bunions is that tissues around the big toe are not balanced; they are too tight on one side and too loose on the other. This imbalance makes the big toe shift toward the other toes.
This can be fixed by shortening some tissues to make them tighter and lengthening others to make them looser.
This type is not usually done alone. It’s commonly done with a bone alignment procedure like osteotomy.
In this procedure, the doctor makes small cuts to realign the joint. With pins, screws, and plates, the bones will be straightened to enable the joint to regain its balance.
In other instances, a wedge of bone will be removed to make enough space to correct and straighten the big toe. Osteotomy is usually paired with repairing tissues.
Types of Osteotomy
- Akin osteotomy
Local anesthesia is usually used under this procedure. The surgeon will make an incision along the big toe and will open the joint capsule. After that, they will remove the bunion with a surgical saw alongside a wedge of bone from the big toe. When the toe is back to its natural structure, surgical staples are placed to hold the toe in place.
- Distal chevron osteotomy
Similar to akin osteotomy, this procedure involves an incision along the big toe and the joint capsule. However, in chevron osteotomy, the surgeon will make a V-shaped cut on the metatarsal of the big toe. The bones will then be moved to its original structure. Screws or pins will hold the toe in the correct position.
This type of osteotomy is for patients with mild to moderate bunions.
- Scarf osteotomy – Scarf osteotomy is performed under general anesthesia; this means you will be completely unconscious during the entire procedure. The first step to this procedure is that the surgeon will make an incision along the big toe and open the joint capsule, exposing the bump. The surgeon will then use a bone saw and remove the lump. After that, the surgeon will carefully make a Z-shape cut on the first metatarsal bone and realign the bones and joints. To close the incision and hold the toe in the right position, pins and screws will be placed.
This procedure is commonly for patients who are suffering from moderate to severe bunions.
- Proximal crescentic osteotomy
There are instances where the first metatarsal bone is angled and rotated away from the second metatarsal bone. This is called metatarsus primus varus, and the suitable procedure for this kind of condition is to have a proximal crescentic osteotomy.The surgeon will make a curved cut at the base of the first metatarsal, release distal tissue and supinate the first metatarsal bone. He or she will then add screws or pins to hold the bones in their rightful place.
This procedure is for patients who are experiencing severe metatarsus primus varus.
Arthrodesis, also called fusion, is a procedure wherein two bones are connected to fuse the joint.In this particular surgery, the doctor will remove the arthritic joint surfaces and allocate stem cells at the end of the bone to encourage healing and union of the two bones. Screws, wires, and plates are then inserted to hold the bones and joints altogether.
Patients who usually undergo this type of surgery are ones with severe bunions, severe arthritis, or ones who previously had an unsuccessful bunion removal surgery.
- Lapidus Procedure
This procedure under arthrodesis entails the infuse and alignment of the cuneiform and the first metatarsal bone. Once the doctor has gained access to the bunion and first-cuneiform joint, he or she will then shave off the bunion on the first metatarsal. Next, the doctor repairs the tendons and ligaments and makes sure all are functioning correctly. In order to align the bones together, he or she will then cut an angled piece from the first metatarsal and cuneiform. Screws or plates are placed to marry the two bones.After this procedure, excessive movement from the affected area will already be limited as it will prevent the reformation of new bunions.
This surgery is quite simple as compared to the others because an exostectomy is where bunion bumps are extracted from the joint. However, this procedure is not 100% guaranteed as it does not ensure that the bunions will not grow back.
This method is seldom used to treat bunions because it does not realign the joint. If so, an osteotomy must be done afterward.
- Resection Arthroplasty
The surgeon removes the damaged areas of the joint and provides more space between the toes to create a flexible “scar” joint.
This operation is commonly done on the elderly, patients with severe arthritis but not suitable for an arthrodesis, and patients who underwent an unsuccessful bunion removal surgery.
What do you do before surgery?
If you opt for your bunion to be surgically removed, you will have a conversation with the doctor. The doctor will perform some tests to assess the condition of your foot. A prime test would be an x-ray of the foot while standing. This is to ensure the doctor can entirely see the issue.
The doctor will then interview you about your medical past and will allow some questions from you if you need clarification. Remember that it’s essential to be healthy before the operation. Eat the right food, avoid alcohol and smoking, and get the proper exercise.
Since you will be sedated and won’t be allowed to use the affected foot, be sure to organize transportation going home. Ask someone to accompany and drive you home.
What happens during surgery?
During bunion removal surgery, you will get a local anesthetic called an ankle block; this will make you numb below the ankle. However, you will be wide awake throughout the surgery.
Once the anesthesia has taken effect, the surgeon will remove the bunion and make the necessary repairs on your foot.
What to expect after surgery?
Right after surgery
Right after the operation, your foot may still be numb if local anesthesia was used, or you may still be asleep or groggy when the surgery is over. You will be taken to the recovery room for observation. There, the sensation and circulation in the foot will be checked. Medical practitioners will also make sure that your blood pressure, pulse, and breathing are stable and healthy. Your stay in the recovery room will also depend on the anesthesia given.
Bunion surgery patients are usually out-patients. This means that they are allowed to go home after a few hours. Patients who are asked to stay in the hospital for further observations only happen on rare occasions.
Recovery at home
When you are released from the hospital, you will be wearing a surgical shoe or cast to protect your foot and will need to be wearing this for a few weeks. Recovery time from surgery can be anywhere from six to eight weeks, although it can take four to six months to recover from bunion removal surgery completely. Your foot doctor will remove the stitches about two weeks after the operation.
There will still be pain and swelling during the first few weeks after the surgery. Fortunately, these will subside as time goes on. The doctor will also prescribe pain-relievers that should be taken as needed and antibiotics to prevent infection. When the cast or surgical shoe is removed, you may need to wear a temporary foot brace for extra support. The doctor will also endorse you to undergo physical therapy and exercise to regain the foot’s strength and range of motion.
Regular appointments are also needed to be sure that you are healing well. Additional or alternate instructions may be given during these check-ups.
How much does a bunion surgery cost?
There is no definitive price on bunion surgeries. The cost procedures will depend on several factors.
There are some high-priced but skilled medical professionals. However, some are also good but are not as expensive. These are some things to consider when looking for a qualified doctor:
- What are the doctor’s medical qualifications and experiences?
- Are the hospitals affiliated with the doctor accredited?
- Are they available for urgent care?
A simple exostectomy is significantly cheaper than complicated bunion removal surgery. The size, condition, and deformity will determine what kind of procedure is necessary.
Risks of bunion surgery
Like any other operation, there are a number of risks with bunion surgery. Although they rarely happen, they can prolong or stop the healing process. The doctors will discuss them with you before you make your decision about going through with it. Some complications may be:
- Risk of infections
- Unsuccessful procedure. This may entail:
- The bunion was not properly or completely removed
- The bunion returned after some time
- Nerve damage. You may feel tingling, numbness or a burning sensation on the area
- No relief of pain
- No relief of swelling
- Bones don’t fully heal
- There will be stiffness at the joint
- Excessive bleeding
- Adverse reaction to medication and anesthesia
- Big toe could become shorter when bone is removed
- Damaged tendons. This could pull the big toe up or down
- Blood circulation problems to the area
- Non-surgical measures
There are a few home remedies you can do to treat or prevent the bunion from worsening.
Some products are available to realign your big toe. These correctors can push it back in and can be bought online. You can put toe spacers between your big toe and the toe next to it. With a doctor’s permission, using a splint at night can keep the toe straight and lessen discomfort. Unfortunately, some medical experts say that devices like this are only a temporary fix. When you take them off, the problem comes back.
On the other hand, some products can prevent the long-term development of bunions. There are moleskin or gel-filled bunion pads available in drugstores. These shoe inserts can keep your foot both aligned and comfortable. They can also either be store-bought or prescribed by a doctor.
Some techniques and measures can treat bunions without the use of devices. The easiest is to wear comfortable and appropriate shoes. Some shoes look good but actually cause harm. Avoid those that are tight around the toe area. Applying ice packs on the inflamed area can reduce pain.
For cases with intense pain but not enough for surgery, you can take pain-relieving medicine prescribed by your doctor. You can also take cortisone injections to bring down pain and swelling. However, because of some side effects, cortisone shots to a patient are limited.
Bunions are a common problem experienced by millions of people. While the majority of bunion cases are not severe, some extreme instances need to be surgically fixed.
If you are experiencing pain, then have it immediately assessed by a medical professional.