From Jonathan Cluett, M.D.,
Your Guide to Orthopedics.
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About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

Surgical bunion treatment may be needed if conservative measures are not adequate to relieve a patients' symptoms. Surgical treatment is aimed at accomplishing a few goals:

• Restoring the normal alignment and mechanics of the foot

• Removing painful prominences and preventing their recurrence

How is bunion surgery performed?
Rarely, the bunion can simply be shaved off, but usually the surgical treatment of a bunion is more extensive-otherwise the bunion will simply return over time.

Bunion surgery involves breaking the toe bone (metatarsal) to correct the alignment. There is also a tightening of the ligaments on the outside of the toe, and a release of the ligaments on the inside, so the tension on the ligaments points the toe in the proper direction.

The major drawback to bunion surgery is that you will have pain in the foot, and probably not be completely healed for about three months. The most common complication of bunion surgery is a recurrence of the bunion months or years later. That said, if bunions are causing you problems in walking, it is certainly reasonable to consider surgical bunion treatment.

Other potential complications of surgery include:

• Inadequate correction

• Overcorrection of the deformity (hallux varus -- the big toe points inward)

• Nerve injury, can cause numbness of the toes

• Infection

What is the rehabilitation from bunion surgery?
The rehabilitation is relatively simple to understand, but it can be difficult to comply with. Patients must wear a special post-operative shoe to prevent pressure and forces to push on the healing bone. Most people will be on crutches, at least until the initial pain has subsided. Bunion surgery can be quite uncomfortable, and may require about 3 months or more to completely heal.

_Sources:

Mann, R. Disorders of the First Metatarsophalangeal Joint J. Amer Acad Orthop Surg; Vol 3, No 1 1995; p 34-43.

Kato, T. & Watanabe, S. The etiology of hallux valgus in Japan. Clin Orthop. Vol 157, 1981; p 78-81.