Definition

Bunion removal is surgery to treat deformed bones of the big toe and foot. A bunion occurs when the big toe points outward toward the second toe, forming a bump on the inner side of the foot.

Alternative Names

Bunionectomy; Hallux valgus correction; Bunion excision; Osteotomy - bunion; Exostomy - bunion; Arthrodesis - bunion

Description

You will be given anesthesia (numbing medicine) so that you won't feel pain.

• Local anesthesia -- Your foot may be numbed with pain medicine. You may also be given medicines that relax you. You will stay awake.
• Spinal anesthesia -- The pain medicine is injected into a space in your spine. You will be awake but will not be able to feel anything below your waist.
• Regional anesthesia -- The pain medicine is injected into your leg. It will numb your lower leg and foot. You may still require general anesthesia to make you sleep through the procedure. However, the amount of anesthesia needed is much less as you cannot feel your leg during surgery.
• General anesthesia -- You will be asleep and pain-free.

The surgeon makes a cut around the toe joint and bones. The deformed joint and bones are lined up using pins, screws, plates, or a splint to keep the bones in place.

The surgeon may repair the bunion by:

• Making certain tendons or ligaments shorter or longer
• Taking out the damaged part of the joints and then using screws, wires, or a plate to hold the joint together so that they can fuse
• Shaving off the bump on the toe joint
• Removing the damaged part of the joint
• Cutting parts of the bones on each side of the toe joint, and then putting them in their proper position

Why the Procedure Is Performed

Your health care provider may recommend this surgery if you have a bunion that has not gotten better with other treatments, such as shoes with a wider toe box. Bunion surgery corrects the deformity and relieves pain caused by the bump.

Risks

Risks of anesthesia and surgery in general include:

• Allergic reactions to medicines
• Breathing problems
• Bleeding, blood clots, or infection

Risks of bunion surgery include:

• Numbness in the big toe.
• The wound does not heal well.
• The surgery does not correct the problem.
• Instability of the toe.
• Nerve damage.
• Persistent pain.
• Stiffness in the toe.
• Arthritis in the toe.
• Worse appearance of the toe.

Before the Procedure

Tell your provider and surgeon what medicines you are taking, including medicines, supplements, or herbs you bought without a prescription.

During the week before your surgery:

• You may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen, (Advil, Motrin), and naproxen (Naprosyn, Aleve).
• Ask your surgeon which medicines you should still take on the day of your surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see your provider who treats you for these conditions.
• Tell your surgeon if you have been drinking more than 1 or 2 servings of alcohol each day.
• If you smoke, try to stop. Ask your provider for help. Smoking can slow down wound and bone healing.
• Tell your surgeon if you get sick with a cold, flu, herpes infection, or other illness before your surgery.

On the day of your surgery:

• Follow instructions for not eating and drinking before the procedure.
• Take the medicines your provider told you to take with a small sip of water.
• Arrive on time at the hospital or surgery center.

After the Procedure

Most people go home the same day they have bunion removal surgery.

Your surgeon will tell you how to take care of yourself after surgery.

Outlook (Prognosis)

You should have less pain after your bunion is removed and your foot has healed. You should also be able to walk and wear shoes more easily. This surgery does repair some of the deformity of your foot, but it will not give you a perfect-looking foot.

Full recovery may take 3 to 5 months.

References

Greisberg JK, Vosseller JT. Hallux valgus. In: Greisberg JK, Vosseller JT, eds. Core Knowledge in Orthopaedics: Foot and Ankle. 2nd ed. Philadelphia, PA: Elsevier; 2019:56-63.

Murphy GA. Disorders of the hallux. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 82.