The Center for Podiatric Care and Sports Medicine

Types of Bunion Surgery

Posted by on Thursday, June 28th, 2012

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We’ve recently talked about how to decide when it’s time to have bunion surgery and how you can make your recovery easier. Now after all that, you may be wondering, “What exactly happens during bunion surgery?”

Good question! Actually, there are a number of bunion procedures; the type your podiatric surgeon chooses will depend on the particular bunion issue you have and the severity of your condition. It’s also not uncommon to have more than one procedure performed to correct multiple bunion problems. Let’s take a look at a few of the most common bunion procedures.

  • Tendon and Ligament Repair Sometimes with bunions the big toe drifts out of place and towards the second toe because the tendons on one side of the toe might be too loose and on the other side too tight. The podiatric surgeon will cut down the loose tendons and elongate the tight ones in order to correct the imbalance that’s allowing the toe to shift out of place. This re-alignment is often done with other bunion surgeries.
  • Arthrodesis This is essentially a fusion of the big toe joint. The worn out joint surfaces are removed and screws, wires, or plates are inserted to hold the bones together until they heal or fuse together. The procedure is often used for patients with advanced arthritis in their toe joint. There is some loss of motion in the big toe. This is often a last resort procedure used when others haven’t worked or when the bunions are extremely severe.
  • Resection Arthroplasty Like arthrodesis, the damaged joint is removed from the big toe, but nothing is inserted to pull the bones together. Instead, scar tissue is allowed to form, creating a somewhat flexible “scar joint.” This procedure is often used in patients who have had previous bunion surgeries, older patients, or patients with severe arthritis.
  • Osteotomy This is the most common bunion surgery. It’s simply a removal of a section of bone to allow for realignment of bones. There are actually three types of osteotomies. A distal chevron osteotomy is performed when the toe joint is still in place with the bunion bump located at the bottom of the toe. A section of bone is simply removed and the bones re-aligned. A Scarf or Ludloff osteotomy is when there is a large joint deformity. This time screws or wires are inserted to hold the re-aligned bones in place as they heal. Severe joint deformities are corrected with a cresent osteotomy, which also requires insertion of some kind of apparatus to hold everything in place.
  • Exostectomy This procedure simply involved removing the bump on the bone. However, as this surgery does not really address the problem of the bunion, it is not performed that often (and to be honest, if your podiatrist suggests doing an exostectomy, you might want to get a second opinion).
  • Mini-tightrope surgery This is a relatively new procedure where thin fiberwires are inserted between the big toe and second toe in order to pull the big toe into alignment.

Your podiatrist will know which procedure is best for your bunion, but of course you should feel free to ask as many questions as you want to make sure you understand what will be happening during your surgery. It’s also very, very important to discuss the probable outcome of the surgery with your surgeon, such as how much mobility there will be, how much the appearance of the bunion will diminish, or how much scarring will be left behind. Many of the people who say they were dissatisfied with bunion surgery feel that way because they were expecting a miracle cure where their feet would look model perfect. The most important thing is to just do something about your bunion; don’t be a hero and ignore it.

If you have any questions about bunions or bunion surgery, you can contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.