Bunion Removal: Surgery, Recovery, And Alternatives

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Medical News TodaySubscribeWhat's the best way to get rid of a bunion?

Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Jayne Leonard on October 19, 2018

Types of bunion surgery
Before the procedure
During the procedure
Recovery
Complications
Alternatives
Takeaway

Bunion removal is when doctors use surgery to remove a bony bump, or bunion, that forms at the base of the big toe. People may require bunion removal if other treatments do not bring relief. It is usually successful.

Bunions can cause intense pain and may increase the risk of other foot problems. Research estimates that up to 23 percent of adults between the ages of 18 and 65 and 35 percent of people over 65 have bunions.

Surgery aims to:

relieve pressure and pain in the foot
repair the toe joint
restore proper foot alignment

This article describes what to expect before, during, and after the procedure. It also includes alternative treatments to bunion removal.

Types of bunion surgery

Doctor or podiatrist checking patients bunion on foot — A doctor will assess the bunion before recommending a type of surgery.

A doctor will select the type of surgery, depending on a person’s symptoms, the shape and size of their bunion, and other factors.

Types of bunion repair involve:

Repairing tendons and ligaments

If tight or loose soft tissues are causing the bunion to form, a surgeon may loosen tight tendons and ligaments or tighten loose ones.

This procedure is usually in addition to others.

Osteotomy

The surgeon cuts into the bone and places pins, screws, or plates into the openings. These devices help to keep the toe straight and reduce misalignment.

It may sometimes be necessary to remove a small portion of bone.

Exostectomy

People typically have an exostectomy in conjunction with other types of surgery, such as soft tissue removal and an osteotomy. Exostectomy involves removing the bony bump from the big toe.

The bunion will often return if a doctor performs an exostectomy on its own because this surgery does not correct the underlying cause.

Arthrodesis

The doctor will remove areas of arthritic joints before using plates, screws, or wires to hold the surfaces together. People with arthritis or severe bunions often undergo this type of surgery.

Resection arthroplasty

The surgeon removes areas of damage from the joint to provide more space between the bones, during this type of bunion removal.

A resection arthroplasty can reduce power in the big toe. It is, therefore, typically for older adults, people with arthritis that an arthrodesis may not treat, and people who have unsuccessfully had other forms of bunion surgery.

Before the procedure

Before surgery, a doctor may request the following tests:

an electrocardiogram, to check heart health
an X-ray of the lungs
urine and blood tests, to detect illness or infection

People should aim to be in good health before undergoing a bunion removal, or any other type of surgery. To maintain good health before surgery, people should:

eat a healthful diet in the weeks before the procedure
exercise regularly, to encourage faster recovery
quit smoking at least 4 weeks beforehand, to reduce risk of infection

A doctor can advise patients about any medications they are taking. It may be necessary to stop taking some types of medication, such as aspirin or warfarin, before having surgery.

The doctor will also explain how long to fast (avoid food or liquids) before surgery. This typically depends on the type of anesthesia a person will have, and the length of time the operation will take.

During the procedure

A doctor will administer anesthesia, either local or general, before they begin. A general anesthetic means the person is unconscious for the procedure. Most people, however, have a local anesthetic, which numbs them below the ankle.

Once the anesthetic has taken effect, the surgeon will perform the surgery. Individuals who are preparing for bunion surgery should ask their doctor for specific details on the type of surgery they will have.

Afterward, the surgeon will then apply a bandage to the foot. Patients will go to the recovery room where staff will monitor them carefully. Until the anesthesia wears off, the team will observe the following :

blood pressure
heart rate
breathing
other vital signs

Most people can go home a few hours after their surgery. They will need to organize transport home before going to the hospital, as people should not drive themselves after general anesthesia.

Recovery after the procedure

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A person may require a surgical boot after bunion removal surgery.

A doctor will provide instructions on recovery, and it is important to follow these steps carefully to speed up healing and avoid complications.

People may need to:

rest and elevate their foot and leg to keep it from moving
take pain medications for discomfort and antibiotics to prevent infection
use ice packs on the foot and toe to bring down swelling
wear a surgical boot for several weeks
use crutches or a knee walker for a few weeks
keep their wound and stitches dry by using a plastic bag over the foot when showering
wear shoes with wide toe boxes to reduce pain and prevent recurrence
avoid wearing high heels for at least 6 months after surgery
see a physical therapist for rehabilitation exercises and techniques

People can begin to place weight back on their foot over time, according to their doctor’s instructions. They may be able to drive after 1 to 2 weeks.

A doctor will typically remove the stitches after 2 weeks, but people may have to continue to wear dressings or a foot brace for 6 to 12 weeks. It can be up to a year before a person makes a full recovery and their foot returns to its regular size.

During this time, individuals may have several follow-up appointments with their doctor, as well as one or more X-rays of the foot to check if the surgery was successful.

It is essential that individuals wear supportive and appropriate footwear to prevent bunion recurrence and avoid complications.

Some people may never be able to wear high heels or shoes with tight toe boxes again. A 2016 study in the Journals of Gerontology suggests that wearing constrictive footwear between the ages of 20 and 39 years old may be a risk factor for the development of bunions.

When to contact a doctor during recovery

During the recovery period, people should contact a doctor if any of the following occur:

the wound dressing comes loose, gets wet, or falls off
blood or drainage fluid soaks through the dressing
medications cause adverse reactions
symptoms of infection appear, including fever, chills, shortness of breath, and warmth or more pain around the wound

Alternatives to bunion surgery

Doctors will usually only recommend surgery when the condition is severe or when other treatments do not work.

People who are unable to undergo bunion removal, or those who do not wish to do so, may find relief from the following:

wearing supportive shoes with a wide toe box
avoiding high-heeled shoes
using bunion pads or shoe inserts, which are available over the counter, to reduce pressure on the toe
taping or splinting the toe into its correct position
wearing a toe spacer between the big toe and the one beside it
applying ice to inflamed feet
taking pain-relieving medicines recommended by a doctor
getting cortisone injections into the foot to bring down pain and swelling
seeing a physical therapist for ultrasound therapy, exercises, and other treatments

Takeaway

According to the American Academy of Orthopedic Surgeons, most people who have bunion surgery will notice an improvement in their symptoms, including a reduction in pain and better alignment of the big toe.

Some research from 2012 suggests that proper surgical treatment offers a good or very good outlook for 85 percent of people and a satisfactory outcome in another 10 percent of those who have the procedure.

Bones / Orthopedics

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Haddad, S. L. (2016, February). Bunion surgeryhttps://orthoinfo.aaos.org/en/treatment/bunion-surgery/
Menz, H. B., Roddy, E., Marshall, M., Thomas, M. J., Rathod, T., Peat, G. M., & Croft, P. R. (2016, December 14). Epidemiology of shoe wearing patterns over time in older women: Associations with foot pain and hallux valgus. Journals of Gerontology: Series A, 71(12), 1682–1687https://academic.oup.com/biomedgerontology/article/71/12/1682/2513750
Wülker, N., & Mittag, F. (2012, December 7). The treatment of hallux valgus. Deutsches Ärzteblatt International, 109(49), 857–868https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528062/

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Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Jayne Leonard on October 19, 2018

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Bunion Removal: Surgery, Recovery, And Alternatives

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Types of bunion surgery

Before the procedure

During the procedure

Recovery after the procedure

When to contact a doctor during recovery

Alternatives to bunion surgery

Takeaway

How we reviewed this article:

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