Bunion removal

  • Definition
    • Bunion removal is surgery to treat deformed bones of the big toe and foot. A bunion occurs when the big toe points toward the second toe, forming a bump on the inner side of the foot.

  • Alternative Names
    • Bunionectomy; Hallux valgus correction; Bunion excision; Osteotomy - bunion; Exostomy - bunion; Arthrodesis - bunion

  • Description
    • You will be given anesthesia (numbing medicine) so that you won't feel pain.

      • Local anesthesia. Your foot may be numbed with pain medicine. You may also be given medicines that relax you. You will stay awake.
      • Spinal anesthesia. This is also called regional anesthesia. The pain medicine is injected into a space in your spine. You will be awake but will not be able to feel anything below your waist.
      • General anesthesia. You will be asleep and pain-free.

      The surgeon makes a cut around the toe joint and bones. The deformed joint and bones are repaired using pins, screws, plates, or a cast to keep the bones in place.

      The surgeon may repair the bunion by:

      • Making certain tendons or ligaments shorter or longer.
      • Taking out the damaged part of the joints and then using screws, wires, or a plate to hold the joint together so that they can fuse.
      • Shaving off the bump on the toe joint.
      • Removing the damaged part of the joint.
      • Cutting parts of the bones on each side of the toe joint, and then putting them in their proper position.
  • Why the Procedure is Performed
    • Your doctor may recommend this surgery if you have a bunion that has not gotten better with other treatments, such as shoes with a wider toe box. Bunion surgery corrects the deformity and relieves pain caused by the bump.

  • Risks
    • Risks for anesthesia and surgery in general include:

      Risks for bunion surgery include:

      • Numbness in the big toe
      • The wound does not heal well
      • The surgery does not correct the problem
      • Nerve damage
      • Persistent pain
      • Stiffness in the toe
      • Arthritis in the toe
  • Before the Procedure
    • Tell your health care provider what medicines you are taking, including drugs, supplements, or herbs you bought without a prescription.

      During the week before your surgery:

      • You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen, (Advil, Motrin), and naproxen (Naprosyn, Aleve).
      • Ask your provider which drugs you should still take on the day of your surgery.
      • If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your provider who treats you for these conditions.
      • Tell your provider if you have been drinking more than 1 or 2 servings of alcohol each day.
      • If you smoke, try to stop. Ask your provider for help. Smoking can slow down wound and bone healing.
      • Tell your provider if you get sick with a cold, flu, herpes infection, or other illness before your surgery.

      On the day of your surgery:

      • Follow instructions for not eating and drinking before the procedure.
      • Take your drugs your provider told you to take with a small sip of water.
      • Arrive on time at the hospital.
  • After the Procedure
  • Outlook (Prognosis)
    • You should have less pain after your bunion is removed and your foot has healed. You should also be able to walk and wear shoes more easily. This surgery does repair some of the deformity of your foot, but it will not give you a perfect-looking foot.

      Full recovery may take 3 to 5 months.

  • References
    • Coughlin MJ, Anderson RB. Hallux valgus. In: Coughlin MJ, Saltzman CL, Anderson RB, eds. Mann's Surgery of the Foot and Ankle. 9th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 6.

      Richardson EG. Disorders of the hallux. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 81.