(Hallux Valgus Repair, Bunionectomy)
A bunion removal is a surgery to repair a deformity in the joint that connects the big toe to the foot. It is done by removing excess bone in the joint area and re-aligning the joint.
Reasons for Procedure
A bunion is an inflammation and enlargement of the big toe joint and the tissue around it. In some cases, the deformity is so severe that the bottom of the big toe slants significantly toward the outside of the foot. Surgery to correct it is considered when:
- Other attempts at therapy have failed, such as anti-inflammatory drugs, physical therapy, specially shaped shoes, or inserts to decrease pressure
- The pain of a bunion interferes with walking
- The foot deformity makes walking difficult
If you are planning to have a bunion removal, your doctor will review a list of possible complications, which may include:
- Toe may be misaligned or too short
- The bunion may recur
Factors that may increase the risk of complications include:
- Smoking and alcohol abuse
- Poor nutrition
- Poor health
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Physical exam, especially of your foot
- Foot x-rays
- Blood work
Leading up to your procedure:
- Talk to your doctor about your medications. You may be asked to stop taking some medicines up to 1 week before the procedure.
- Arrange for a ride to and from the procedure.
- Arrange for help at home after the procedure.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- You may be asked to shower the morning of your procedure. You may be asked to use a special antibacterial soap.
Depending on the complexity of the surgery, you may be given:
- Local anesthesia—The area will be numbed.
- General anesthesia—You will be asleep.
Description of the Procedure
There are several types of bunion removal procedures. A cut will be made into the foot near the bunion. The excess growth of bone will be removed with a bone saw. Depending on the degree of deformity, the doctor may need to cut into the bone of the toe. The bones will then be realigned so that the toe no longer slants to the outside. Other revisions may be needed as well. Improving the angle of the toe and repairing these bones may require a metal pin, screw, or rod to hold the bones in place. The incisions will be closed with stitches. A bulky bandage will be placed over the area.
Will It Hurt?
Anesthesia prevents pain during surgery. You will have pain after the surgery. Talk to your doctor about medication to help manage the pain.
At the Hospital
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
- Pain medication
- Bandaging your foot
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chances of infection, such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
When you return home, take these steps:
- You may need to wear a special postoperative shoe for several weeks.
- You will be given instructions about whether you may bear weight on your foot. You may need to wear a splint or cast. You may need to use crutches or a walker for a brief time.
- After your foot has healed, you may need to do specific exercises or physical therapy. They will help you regain strength, flexibility, and stamina in your feet.
- Talk with your doctor about the kind of footwear you should use. Make sure that it fits correctly.
- If pins were used in your feet, you may need to have these removed several weeks after your operation.
- Be sure to follow your doctor's instructions.
Bunion removal may result in better movement with less pain. It may take as long as 8 weeks after bunion surgery for your foot to be well healed.
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the site
- Pain that you cannot control with the medicines you have been given
- Swelling or pain in the calf or leg
In case of an emergency, call for emergency medical services right away.
American Podiatric Medical Association
OrthoInfo—American Academy of Orthopedic Surgeons
Canadian Orthopaedic Association
Canadian Podiatry Education Foundation
Bunion surgery. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00140. Updated September 2012. Accessed March 2, 2015.
Ferrari J, Higgins JP, et al. Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database of Systematic Reviews. (1):CD000964, 2004.
Foot care. National Institute on Aging website. Available at: http://www.nia.nih.gov/health/publication/foot-care. Updated January 22, 2015. Accessed March 2, 2015.
Last reviewed March 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.