Bunions can be many things: painful, unsightly, frustrating, maddening. One other attribute they share is that they are progressive. No, that’s not a political statement—it just means that, without treatment, they tend to get worse over time.
In the early stages, a variety of conservative strategies may be employed to resolve bunion pain and keep them from getting worse. However, when bunion pain is severe, impairing your daily activities and not responding to conservative care, a surgical remedy will usually be necessary.
Surgical Approaches and Procedures
The important thing to remember about bunions is that every foot, and every person, is unique. Our surgeons will therefore need to customize an approach that considers the severity of the deformity, along with other factors—for example, your age, interests, activity level, etc.
Possible techniques and procedures for bunion surgery include (and may involve a combination of):
- Soft tissue repair. The surgeon may loosen, tighten, or transfer tendons and ligaments in order to reduce stress on, or reinforce, a joint. This is generally performed alongside an osteotomy.
- Osteotomy. Here, the surgeon cuts the bones in order to reposition and realign them properly. Then, internal fixation (such as screws) is used in order to keep the bones in the proper position during the healing process. This, coupled with soft tissue repair, is the most common surgical approach to fixing a bunion.
- Arthrodesis. The surgeon removes the damaged joint surfaces, then fixes the bones in place so that they fuse together during the healing process. This does reduce joint mobility permanently, but also alleviates pain. It may be selected for patients with severe bunions, severe arthritis, or who have had previous unsuccessful bunion surgeries.
- Resection arthroplasty. The surgeon removes the damaged joint surfaces and leaves a flexible “joint” made from scar tissue. This may reduce push-off strength in the affected foot, but might still be appropriate for older patients who are not good candidates for osteotomy or arthrodesis.
- Exostectomy / bunionectomy. Here, the surgeon simply removes the enlarged mass of bone at the side of the joint. Since this does not correct the underlying misalignment, it is usually used in combination with another procedure, such as osteotomy.
The Day of the Surgery—What to Expect
We perform virtually all our bunion surgeries outpatient and at one of our local offices—hospitalization is not required. We’ll have you arrive a couple of hours before the procedure is scheduled to begin, and barring complications, you’ll be able to return home the same day.
We can provide general anesthesia if that’s what you’d prefer. However, most surgeries are performed only with local or regional anesthesia. Once the surgery is finished and the foot has been bandaged, we will continue to monitor you for a few hours (or until the anesthesia wears off). Then, if everything checks out, you can head home.
The Recovery Process
Full recovery times for bunion surgery vary based on a number of factors, including the extensiveness of the surgery and your ability to follow post-operative care guidelines faithfully. Under ordinary circumstances, a basic expectation might be around 6 weeks to 2 months for the initial healing phase, and 3-6 months total for a complete recovery.
In the first few weeks it will be important to keep weight off the affected foot. Medications, icing, and keeping your feet propped up will help with the initial pain and swelling that are common after surgery. You’ll also need to keep any dressings clean and dry. Typically, the sutures are removed after about two weeks, though you may still need support from a walking boot, cast, or brace.
Gradually—and only as directed—you can begin to return to previous activities, such as walking, driving, or wearing normal shoes. At this time, it will be very important to follow directions for stretching, exercises, and physical therapy in order to restore strength and flexibility to your foot.
While all surgical procedures involve some degree of risk, including infection or recurrence, bunion surgeries tend to be highly successful on average—especially when patients participate in the healing process and follow post-op instructions faithfully. Although full healing will take a few months, the end benefit—freedom from pain and the ability to pursue your goals without restriction—is more than worth it!
At Advanced Foot & Ankle Specialists of Arizona, our experienced surgeons will help you through every step of the process, from the original consultation through the day of surgery and beyond. We’re dedicated to providing the highest quality care, and ensure you get the preparation, guidance, and treatment you deserve. To schedule an appointment with us in either Gilbert or Chandler, please call (480) 963-9000 today.