A bunion or hallux valgus is a condition whereby your big toe develops a bony bump on the side of the big toe joint. The bony bump occurs when the big toe turns inward, pressing or overlapping the smaller toes, changing your foot alignment. Bunions gradually develop over time and become painful, swollen, tender, and sore. The outer skin around them thickens when the bump is pressurized by footwear. Poor alignment of the big toe may also cause pain and discomfort.

Are there non-surgical treatments for bunions?

Nonsurgical treatments for bunions are always the first step. They include taking topical or oral medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, wearing wide-toed comfortable shoes, using toe spacers, bunion gel pads, or moleskin pads, and splints. Toe spacers are placed between the big toe and second toe to hold them apart, ease pain, and help with toe alignment, but they will not eliminate the bunion. Surgery is the best option for toe alignment.

Who is a suitable candidate for bunion surgery?

Bunion surgery is performed on patients with mild to severe bunion deformities and pain affecting their daily lives even after wearing more comfortable foot gear. If toe spacers and other remedies have failed and you are still in pain, consult your healthcare provider about bunion surgery.

What is the surgery for bunion correction?

Bunion correction surgery is known as bunionectomy or metatarsal osteotomy. There are different types of surgeries; they generally involve making an incision into the bone and realigning the tendons or ligaments around your toe joint with metallic screws or plates. The surgeon closes the wound with stitches and bandages the area for proper healing. 

The surgery also minimizes the appearance of a bump at the side of the foot. Depending on the severity of the condition, the procedure can take 45 minutes to 3 hours. Traditional surgical techniques are painful and have an extended downtime as they involve large incisions, unlike minimally invasive procedures. 

What happens during minimally invasive bunion surgery?

Tiny multiple incisions are made through the skin of the foot then the metatarsal bone is cut using a burr instead of a saw, unlike traditional techniques which make long incisions. The tiny incisions ensure minimal disruption to soft tissues leading to reduced swelling and pain after surgery. 

Minimally invasive surgery allows for immediate weight-bearing and faster healing enabling patients to resume their usual activities quickly. Depending on the severity of the condition, our surgeon at Dynamic Foot and Ankle performs two types of minimally invasive surgery, including:

  • The Percutaneous Chevron Akin (PECA) technique for mild to moderately severe bunions involves cutting the big toe and the metatarsal bone to reposition and realign them.
  • The minimally invasive (MIS) Percutaneous Lapidus technique for severe bunions involves repositioning and fusing a joint close to the arch and cutting the toe bone. This technique is perfumed using a burr and placing screws through micro incisions.

Both techniques allow you to get back on your feet quickly, have early weight-bearing, minimal pain, aesthetic appeal, and lower the risk of postoperative infections.

What are the advantages of minimally invasive over open bunion surgery?

With a minimally invasive technique, patients can wear regular shoes in half the time than open surgery. Other benefits include:

  • Faster recovery time leads to a quick return to regular activity
  • Reduced surgery time  
  • Less pain, joint stiffness, damaged tissues, or external scarring
  • Improved range of motion in the big toe
  • Early weight-bearing (first day)  
  • Less pain medication
  • Better cosmetic results
  • Less risk of infection

Open bunion surgery has more compelling results for extremely severe bunion deformities and minimizes the risk of severe bunion recurrence.  

Can I have minimally invasive bunion surgery?

A physical examination and an assessment of weight-bearing X-rays have to be conducted. An X-ray helps determine the best treatment option for your bunion. You may require open surgery in case of severe bunion deformity is associated with other foot issues. Your orthopedic foot and ankle surgeon will inform you about the best procedure for you. 

Is bunion surgery painful?

Traditional bunion surgery is more painful than minimally invasive surgery. You will not experience pain during surgery since general anesthesia is used, and a sedative may be administered for more comfort.

The amount of pain experienced after surgery varies from person to person. After the procedure, you will be given a nerve block to numb the pain for 24 hours and pain medication such as ibuprofen and acetaminophen for three days. You may experience more pain if the surgery is performed on a large area of your foot.

How long should you stay off your feet after bunion surgery?

Patients are advised to keep their feet dry and stay off their feet for the first two weeks. It is necessary to keep the foot elevated for the first two weeks, especially in the first week, to avoid pain, swelling and fasten wound healing.

For PECA surgery, you can put weight on your foot after 24 hours and two to four weeks with the minimally invasive Lapidus surgery. Typically, patients take at least two weeks off work or longer if they drive or commute by public transport.

What is the recovery time for bunion surgery?

Recovery time depends on whether you had minimally invasive or open surgery. With minimally invasive surgery, patients can walk in usual sneakers or comfortable shoes six weeks after the PECA procedure and eight weeks after the MIS Lapidus surgery.

If you had open surgery, you could walk in regular footwear after 10 to 12 weeks, and you can’t put weight on your foot after six to eight weeks. Activities like jumping and running are not allowed for 12 weeks, while walking, swimming, and biking can resume as is tolerated. Contact and racquet sports can resume 4 to 6 months after surgery. Consult your healthcare provider before undertaking any sporting activities.

Minimally invasive bunion surgery recovery

After a PECA procedure, you will bear full weight on your foot almost immediately because you will be fitted with a surgical post-op shoe. It is essential to have feeling in your foot before weight-bearing. It is necessary to restrict activities and elevate your foot 50% to 80% of the time to allow the foot to heal and decrease swelling.

After the first 14 days, you may moderately increase walking and resume usual activities. You must continue wearing the post-op shoe for six weeks after the procedure. You may also be given a bunion splint at two weeks to maintain post-surgical alignment.

When can I wear normal shoes after a minimally invasive surgery?

Depending on your level of swelling and comfort, you can start wearing an ordinary sneaker after six weeks. Continue wearing the special post-op shoe for six weeks after surgery. You will not be able to drive for six weeks if your right foot is operated on, and if the left foot is operated on, you can begin driving short distances in an automatic car after two weeks.

Most patients wear comfortable strappy sandals, short heels, sneakers, and boots by three months post-operatively. Avoid wearing high-heeled shoes. It is normal to experience some degree of swelling from time to time, 6 to 12 months after surgery. If the surgery involved a hammertoe correction, it should take longer to wear a regular shoe.

Are bunion surgeries successful and what are the risks?

Bunion surgery is a very successful procedure for pain relief and toe realignment. Most patients are happy with their bunion operation outcome as long as they follow postoperative instructions keenly.

All surgeries have some inherent risks. However, bunion surgery has relatively rare risks. Some rare complications may arise, such as:

  • Delayed bone healing is common after a Lapidus procedure with increased risk from early weight-bearing, diabetes, and smoking. It is rare, and patients would have to undergo surgery again.
  • Infections are rare, but if they occur, antibiotics are prescribed.
  • Mild numbness around the incision area goes away after 3 to 6 months. Occasionally, it may persist but shouldn’t cause discomfort or hinder your activities or ability to wear shoes.
  • Bleeding and clotting are very rare; however, inform your doctor if you have a family history of blood clots since it can increase your risks.
  • Under correction and overcorrection are rare; additional surgery is necessary if it occurs. Bunion recurrence is possible after any correction. However, it is not common in minimally invasive bunion surgery.

Can bunions grow back after surgery?

Even after successful surgery, the bunion recurrence rate is about 20% over a patient’s lifetime. Bunions are genetically inherited and may tamper with surgical results in some patients. Mild bunion recurrence may occur and is well tolerated by patients and tends to occur over a long period.

Recurrence may occur depending on the technique used and if the bunion was not fully corrected during surgery. Patients who do not follow the postoperative instructions carefully may also experience a recurrence. A surgery that corrects a misalignment issue that caused the bunion has a long-term success rate.

How can I prevent another bunion?

Having bunion surgery that fully addresses the severity of the bunion is the best way to avoid a recurrence. It is essential to follow your podiatrist’s recommendations carefully after surgery and heed follow-up advice. Additionally, since bunions are inherited, a recurrence is likely.

Bones that do not heal properly, conditions causing hypermobility or tissue flexibility can also cause a recurrence. Patients are advised to wear comfortable flat shoes to help maintain their bunion correction surgery. Other methods to avoid recurrence include customized physical rehabilitation, avoiding wearing tight shoes, wearing removable splints, and custom orthotics.

If you have been experiencing bunion pain, book an appointment with Dynamic Foot and Ankle Center for a thorough, minimally invasive bunion correction. We provide the best foot and ankle solutions at any of our branches in Virginia. Contact us today or book online now.