| THE PROBLEM
A bunion, also called a "hallux valgus" deformity, occurs
when the big toe begins pointing toward the outside of the foot.
This makes the joint at the bottom of the big toe stick out, and
sometimes some extra bone also forms in this area to make a bump.
In most adults, bunions come from a lifetime of wearing tight shoes,
but we don't know why some people seem more likely to get them than
others. We also don't know why some people that have bunions have
a lot of pain and others do not.
If the bunion is too severe, the big toe will crowd the second
toe. This creates a hammertoe deformity which may also need to be
corrected.
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| THE
SURGERY
There are a variety of different bunion surgeries, and we must
individualize the choice of the procedure to your particular foot.
Most of the time, we have to cut the long bone that leads to the
big toe (the "first metatarsal"). This can be done at
either end of the bone depending upon how bad the bunion is. We
also shave off any extra bone that has formed to eliminate the bump
on the inside of the foot.
Some patients have a little arthritis in the joint at the base
of the big toe. If the arthritis is too severe, the only way the
bunion can be fixed is by fusing the joint (making the two bones
grow together). Other patients have no arthritis and have very good
motion of the joint to begin with. Because all surgery makes some
scarring, it is possible to lose a little motion in the big toe
following bunion surgery. |
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If any of your small toes are cocked up ("hammertoes"), we
can take care of them at the same time. Usually we take one small joint
out of the toe and hold it straight with a pin until it has healed enough
that it will stay straight on its own.
AFTER THE SURGERY
The surgery is done as an outpatient (You do not need to be admitted
to a hospital).
DAY OF THE SURGERY: You will have a tight ACE wrap on after the surgery
to control bleeding. YOU SHOULD TAKE THIS OFF 6 HOURS AFTER THE SURGERY.
Leave the bandage underneath in place.
| 1-3 DAYS, EVERY WEEK FOR 8 WEEKS: Because
the first dressing is put on tightly, we need to see you in the
office within the first few days to put a new one on. We then see
you every week for 8 weeks to put on new dressings. These hold the
toe in the proper position and keep the swelling down. If you have
a pin in a small toe, it comes out at 4 weeks. You can walk in a
hard-soled shoe we will give you. |
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2 MONTHS: We will let you return to regular shoes. We usually check you
again a couple more times after you you do to make sure the toe stays
in good alignment.
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