What is a Bunionectomy?

Pressure from tight shoes or arthritis can cause the toe bones to move out of place. Over time, bony bumps called bunions can develop at the joint at the base of the toe, known as the metatarsophalangeal (MTP) joint. Bunions most often occur on the big toe (hallux valgus) or the little toe (bunionettes or tailor's bunions).

Sometimes bunions can become painful and make it difficult to move the joint. Wearing more comfortable shoes, icing or cushioning the bunion, or taking medication, such as aspirin, may help relieve pain. If your symptoms do not improve, a surgical procedure called bunionectomy may be recommended. Surgery removes the bony bump and, in most cases, treats the misaligned MTP joint by removing and repositioning bone.

There are several types of bunionectomies, and the type performed depends on the severity of the bunion. Some of the most common bunionectomy procedures include:

  • Exostectomy, which is typically used for mild bunions. An exostectomy removes the bunion, but it does not move the bones of the MTP joint back into place. If performed alone, the bunion may return, so exostectomy is often done with other bunionectomy procedures.
  • Joint replacement, which can be performed for severe bunions or when the MTP joint is stiff and painful to move. In a joint replacement procedure, part of the bones are removed and replaced with an artificial joint (prosthesis).
  • Resection arthroplasty, which is often used for older patients or those who have had previous bunion surgery. A resection arthroplasty involves removing some of the arthritic bone and reshaping the joint. Scar tissue forms in place of the removed bone, allowing the joint to move more freely.
  • Osteotomy, which may be performed for moderate or severe bunions. During an osteotomy, the bones at the joint are cut and realigned. The bones will be held in place by screws or other hardware.
  • Arthrodesis, or joint fusion, which is considered a last resort procedure for patients who have severe bunions or have had previous bunion surgery. During a joint fusion procedure, the arthritic or damaged portions of the bone are removed, and screws and pins are used to fuse the bones of the joint together. This procedure reduces the movement of the joint.

Typically, you may return home within a few hours after surgery. Recovery may take anywhere from 3-12 weeks, and you may need a cast or crutches.

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