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Frequently Asked Questions

Active Bunion surgeons from TPMG Orthopedics and Crystal Clinic Orthopedic Center contributed to the following answers to your questions.

Which bunion surgery is best?

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Unfortunately, there is no single “best” bunion surgery. There are more than 100 surgical procedures and variations, each with pluses and minuses. The best surgical procedure is the one that is least invasive and specific to you (age, general health), the severity of your bunion, and your work and lifestyle.

Surgeries that use the smallest incision (minimally invasive procedures) can offer a faster recovery to get you back in regular shoes and doing your usual activities. But minimally invasive surgery is not always right for every case.

It is essential to have a thorough evaluation and to discuss your type of bunion and expected outcomes with your surgeon, and to follow his or her recommendation.

Why bunion surgery?

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A bunion causes pain via pressure on the small nerves that run up to the tip of the big toe, often resulting in persistent inflammation and significant discomfort. Bunion surgery corrects the bump that appears along the big toe joint. A doctor will surgically move the bone into a better position to make the big toe straight, making the bump — and the pain — go away.

Previous surgical approaches would simply remove the protruding bump — but doing only this usually produces the poorest results.

Modern bunion surgery addresses the bunion as a part of the foot, considering the alignment of the big toe and the bones in proximity to it. And only surgery can correct the foot alignment.

When is bunion surgery necessary?

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When a bunion is present, the big toe joint is not functioning properly. Normally, the big toe joint should take up as much pressure when you walk as all the smaller joints going to the other four toes combined.

Surgery becomes necessary when:

  • The bunion is painful or causes pain in other areas of the foot because the big toe joint is not doing its part when you stand and walk.
  • The pain and discomfort of the bunion is no longer responsive to non-surgical remedies and is deemed chronic.

How painful is bunion surgery?

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Current techniques generally minimize the immediate and recovery pain for most people. The use of long-acting block anesthesia dramatically reduces the pain immediately after surgery. The use of stable bone fixation with metal plates and screws work to keep the bones still.

With surgical approaches that use fewer incisions inside and out, the soft tissue correction component of the surgery may be minimized, which can help reduce pain and deep-tissue scar formation after surgery.

Is bunion surgery outpatient?

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Yes. Bunion surgery is typically performed as an outpatient procedure. For relatively few people, there may be a medical need for a short-stay hospitalization.

What does bunion surgery cost?

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The cost of bunion surgery is variable, depending on the region of the country, type of insurance you have, whether it is done at a hospital or surgery center, and the type of products used during the surgery.

It's essential to understand the different components involved. Of course, the surgeon is to be compensated, which typically includes up to three months of aftercare. In addition, hospital charges will consist of time in the operating room, surgical supplies, and implants, and needed imaging studies. An anesthesiologist will also be involved.

Ask your surgeon about the estimated cost for your procedure.

What is the recovery time from bunion surgery?

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Generally, most procedures will have patients back to regular shoes in a few weeks and returning to full activity in six to eight weeks. Some people will heal quicker than others; if you’re younger and healthy, the healing is faster. If you have diabetes, the recovery will be slower. But recovery is highly dependent on several factors.

Consider recovery in three phases:

  • The first is the skin healing, or when the skin sutures will be removed. This varies from ten to 14 days.
  • The second is bone healing. While a small number of people will require either a longer time to heal or another surgical intervention, most can anticipate a period of six to 12 weeks.
  • The third phase is the resolution of stiffness, weakness, and swelling. For many, this may be as short as three months and others up to 12 months. The swelling is often the reason for an inability to wear comfortable shoes.

Does bunion surgery work?

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Bunion surgery, while very common, is highly complex. But due to the advances in technology and years of experience by seasoned orthopaedic and podiatric physicians, bunion surgery is now extremely successful and delivers very good resolution of the symptoms, especially when performed with current and newer techniques.

Other bunion surgeries vs. 3D Lapidus

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The 3D Lapidus procedure is perceived as being new, but the surgical approach was first developed nearly one hundred years ago. Currently, several companies promote this surgery with slightly different names.

Broadly, the surgery realigns the first metatarsal and permanently stiffens the base joint via fusion. Fusion means taking two bones that were not designed to be connected and making them join as one solid bone. There are also the additional risks of those two bones not actually healing properly, which can cause pain and may require further surgery, and a visible shortening in the length of the big toe.

This fusion surgery is a very good option for people with extremely severe bunion deformities or those with advanced arthritis. However, it is not needed by most people with bunions. A 3D Lapidus procedure requires a much bigger incision, which can lead to a longer recovery.

What are the available bunion surgery options?

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There are several general options for bunion surgery. A bunionectomy generally treats smaller bunions and milder big toe deformations. Excess bone of the bunion is removed before realigning the bones and tissues of your foot to restore its natural shape. An osteotomy is a more complicated and generally reserved for mild or severe bunions. During an osteotomy, the metatarsal bone of the big toe is cut and moved into proper alignment to correct a more severe deformity.

While there are approximately 300,000 bunion surgeries performed in the U.S. annually, this is not simple surgery. Obtaining a second opinion from an experienced surgeon is in your best interest. If surgery is not urgent, take time to get comfortable with your surgeon’s recommendation and how the procedure will impact you in the short term.

How do bunions form?

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Bunions mostly form due to extra motion around the joint leading to the big toe. While genetics generally plays a role in bunion development, they can form from trauma to the joint, or other external factors such as footwear preferences (tight, higher heeled shoes will place the toes in a cramped position) or physical activity. Women are more likely to develop bunions than men.

Over time, the bunion forms from stretching of the tissues at the visible bump, as well as at the base of the metatarsal bone in the middle of the foot. People with flat feet may be prone to bunion development.

Can bunions be corrected without surgery?

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The short answer is no. Nonsurgical treatment can keep joints supple and strengthen the muscles. Pads prevent rubbing of toes against each other, and shoe modifications can very often eliminate some of the symptoms. While there is clear value to these techniques, none of them can or will realign the bone to correct the bunion.

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Active Bunion?

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