A bunion is a bony bulge along the edge of the foot, next to the base of the big toe. The skin over the bunion might be red and sore. Smaller bunions (bunionettes) can develop on the joint of your little toe.
A surgical procedure may become appropriate when your bunion causes frequent pain or interferes with your daily activities.
Goals of bunion surgery include:
Because bunions vary in size and shape, there are different surgical procedures performed to correct them. Below are the most common foot surgeries and procedures used to correct this condition:
Osteotomy - When small cuts are made in the bones to realign the joint. After cutting the bone, the surgeon fixes this new break with pins, screws or plates. The bones are now straighter and the joint is balanced. In addition to cutting the bone, a small wedge of bone may be removed to provide enough correction to straighten the toe. Osteotomies are normally performed in combination with soft tissue procedures as both are often necessary to maintain the big toe alignment.
Arthrodesis - In this procedure, your foot surgeon removes the arthritic joint surfaces, then inserts screws, wires, or plates to hold the surfaces together until the foot bones heal. Arthrodesis is commonly used for patients who have severe bunions or severe arthritis or for patients who have had previous unsuccessful bunion surgery.
Exostectomy - When the foot surgeon removes the bump from the toe joint. Exostectomy alone is seldom used to treat bunions because it does not realign the joint. Even when combined with soft tissue procedures exostectomy rarely corrects the cause of the bunion. Exostectomy is most often performed as one part of an entire corrective surgery that includes osteotomy, as well as soft tissue procedures. If a foot surgeon performs exostectomy without osteotomy the bunion deformity often returns.
Resection Arthroplasty - When a foot surgeon removes the damaged portion of the joint. This increases the space between the bones and creates a flexible ‘scar’ joint. Resection arthroplasty is used mainly for patients who are elderly, have had previous unsuccessful bunion surgery, or have severe arthritis not amenable to an arthrodesis (see above procedure). Because this procedure can change of the push off power of the big toe, it is not often recommended.