Treatment of Bunions
The initial treatment for bunions should be non-operative. However if this fails and the patient has significant symptoms then surgery should be considered.
The type of surgery depends upon the severity of the deformity and the presence of arthritis.
Soft tissue re-alignment
This is reserved for mild deformities. The prominence of the bunion is removed and the soft tissues are tightened- helping to straighten the toe.
This is for mild, moderate and severe deformities. During this procedure the bone is broken, re-aligned and then fixed- as to align the toes in a more normal position.
This involves fusing the joint- which completely stiffens the metatarsophalangeal joint (base of big-toe). It is advised in some patients with severe deformity, rheumatoid arthritis or osteoarthritis.
Excision Arthroplasty (Keller’s procedure)
This operation is usually reserved for elderly patients who have a low functional demand. It involves removing part of the bone of the great toe and letting it fill up with scar tissue. It requires a wire that protrudes from the skin for a period of around 4 weeks. This wire is removed in the clinic- leaving a painless, floppy, straighter toe.
After surgery a large dressing will be applied to the foot and you will be placed in a surgical boot and allowed to weight bear. Depending upon the type of operation you may have temporary wires protruding out of the skin. These are generally removed about 4 weeks after surgery.
The boot is removed at 6 weeks after the operation.
Most people find their feet swollen for 3 months after the operation, swelling can be reduced by elevating the foot.