The Center for Podiatric Care and Sports Medicine

Should I Get Bunion Surgery?

Posted by on Thursday, May 16th, 2013

An estimated 23% of adult Americans suffer from bunions, according to a review of studies published in 2010 in the Journal of Foot and Ankle Research. More than two-thirds of people over age 65 will suffer from them, but the popularity of high heels is causing a number of young women to see doctors regarding their bunions. In fact, the American Academy of Orthopaedic Surgeons (AAOS) reports that more than half of women in America get bunions, and that women are nine times as likely as men to have the problem.

Bunions are an enlargement of the big or small toe joints, caused by misalignment and (often) added bone formation. Usually they can be treated without surgery, but bunions can be unsightly enough for people to wish for their removal. One’s first impulse might be to go in for surgery and “just get rid of it.” However, the decision to get any type of surgery is a hefty one. With any type of invasive intervention, there are always risks of bleeding, poor wound healing, infection, nerve damage, and other complications.

 

Bunion Treatments

According to MedicineNet.com, nonsurgical bunion treatments include:

– Rest
– Wearing wider shoes or sandals
– Taking anti-inflammatory medications like Advil, Motrin or Aleve
– Stretching
– Custom insole orthotics
– Local injections of cortisone, and
– Antibiotics for skin aberrations.

For people with severe pain, there are several types of bunion surgery to consider. An exostectomy involves the thinning of the first metatarsal bone with a surgical saw. More serious cases of angular deformity may require a joint-fusion procedure called a lapidus bunionectomy, where the first metatarsal and the cuneiform bone are fused together. Surgeons warn against seeking a bunionectomy for cosmetic reasons, as the main goal for medical professionals is to alleviate pain. However, Neal M. Blitz DPM tells the Huffington Post, “People do have surgery for non-painful bunions if the bunion interferes with activity, continues to become larger, or if they have difficulty wearing certain shoes and/or if the bunion is simply unsightly.”

Pros of Bunion Surgery

  • Wellness: A bunionectomy can correct deformity, relieve pain, improve foot function and restore quality of life.

Bunion Surgery Cons

  • Success: There is no guarantee bunion surgery will be successful. The Wall Street Journal reports that bunions come back between five and 20% of the time. “Generally the more aggressive the surgical procedure the less chance a bunion will recur,” they add. Also, choosing the right type of footwear and getting fitted with custom orthotics can increase the likelihood for long-term success.
  • Complications: “Complication rates from various studies range from 10% to 55%,” with the most common complication being the recurrence of the bunion, according to a Harvard Women’s Health Watch newsletter from June 2011. Nonunion,” when the cut bone doesn’t come together with the surrounding bone, is another complication — and one that requires another surgery. Some people experience irritation from pins or screws holding the bone together, while others report scarring, stiffness, or swelling that lasts for months. Nerve damage and continued pain are rare side effects, and infection is only reported in less than one percent of all patients.
  • Recovery: Most bunion surgeries take between six and 12 weeks for immediate recovery. During this time, crutches or surgical boots may be needed. However, most people can return to a desk job within two weeks. The AAOS explains that “a long recovery is common and may include persistent swelling and stiffness.” Dr. Ira Fox, DPM, head of Shore Orthopaedic University Associates Foot and Ankle division, says the “maximal medical improvement” will not be seen until 12 to 18 months. “The time to do the surgery is when you are prepared for the post-op inconvenience,” he writes. “No magic wand treatment is available.”

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.