The main goal of bunion surgery (bunionectomy) is to better align the big toe joint (1st MPJ). A bunion deformity is the result of a slowly progressive joint dislocation process that can occur slowly throughout a person’s life. Over-pronatory (excessive lowering of the arch) foot positions add extra stress to the big toe joint and is known to accelerate the formation of these painful joint conditions. Orthotics (arch supports) can be very helpful in slowing the progression of a bunion and are usually always recommended after bunion surgery to reduce any re-occurrences of the bunion.
Most foot deformity has an underlying genetic basis.
Typical bunion surgery is done in an outpatient surgical facility with IV conscious sedation. Your surgeon will pick the most appropriate type of procedure based on a number of factors which include but are not limited to the age of the patient, overall health, the severity of bunion deformity, any pre-existing arthritis within the joint, and specific anatomic features of the joint/foot/toe.
Most (but not all!) types of bunion corrections require implanted hardware to stabilize the correction (surgical grade pin, screw).? These are often never required to be removed and are not a large enough quantity of metal to be detected at the airport.
A typical post-operative recovery will include crutches for 1-2 weeks, and then protected walking either in a post-op shoe or walking boot for 4-6 weeks. Limited exercise can usually start again at 6 weeks. On average, most people are back to their full activity at the 12 weeks post surgery. Swelling of the foot/toe is expected and can take anywhere from 6 weeks to 6 months to fully resolve.
Activity after surgery will be limited. A stationary bike or swimming is typically safe after the sutures have been removed. Sutures are generally removed at the 2nd post-op visit, 10-14 days after the initial procedure. Load-style activity like walking or running is usually not safe until the bones have mended with good strength, 6-12 weeks post-op.
Driving is allowed almost immediately if the surgery is LEFT-SIDED, and the car is an automatic. Driving for RIGHT-SIDED feet will take anywhere from 2-6 weeks, and will depend on the individual.
Appropriate expectations from having your bunion corrected should include less pain about the joint, and a straighter big toe. The surgeon’s goal is not to make a perfectly straight big toe joint, rather, to re-align the 1st MPJ into a more anatomic position which is something usually only appreciated on x-ray. There will be multiple x-rays taken to follow your healing progress during your post-operative course.