Bunions: Treatment Options

Bunions: Treatment Options

Seeking the right treatment for a bunion is important for a patient to get back to their normal activity. If left untreated, mild to moderate bunions can progress to severe deformities. Affecting the movement of the toe and even the ability to walk or balance normally.

Patients can decide to try non-operative treatment if they have a mild or moderate bunion to try and avoid surgery. One easy change is to start wearing shoes with a wider toe box and avoid wearing high heels. Some therapists will recommend using tape or splints to straighten out the toe.

Doing physical therapy that includes foot and toe exercises along with different stretching techniques can help, too. Simply avoiding activities that hurt can help with symptoms as well. Using orthotics or shoe inserts can help to correct foot position.

If non-surgical treatment isn't helping, a patient can talk to a surgeon about whether surgery is right for them. First things first, it's important to know that the general term for fixing a bunion is a bunionectomy. It essentially means removing the bump on the foot by lining up the big toe.

Almost all of these procedures will include what is called an osteotomy, where the surgeon cuts the bone to realign the toe. The following procedures are some of the more common procedures used to surgically treat a bunion.

The modified McBride is when the surgeon removes the bony bump on the inside of the toe and then repairs the soft tissues here that have stretched and become thin and weak. Sometimes, a flat suture is used to help support this repair. During the early phases of healing.

This is typically used together with an osteotomy of the metatarsal bone here, where the surgeon will cut through the bone and then shift it to straighten the toe. It is held in place with a plate and screws. This cut in the metatarsal bone can happen at either end of the bone. Proximal toward the ankle or distal toward the end of the toe.

In the distal Chevron osteotomy, the surgeon still trims off the bump on the inside of the big toe but then makes a cut in a v-shape at this end of the metatarsal. This allows the toe to be shifted over into better alignment. It is then fixed in place with screws.

A more minimally invasive option includes using small incisions and a drill guide to shift the bones and place the screws without a large open incision. In some cases, this joint may be very unstable and shift around a lot. Here, the surgeon may decide that a better idea is to fuse these two bones together.

They would remove all the cartilage and then hold the two bones together with a plate and screws, allowing them to grow into one. This is called a Lapidus procedure. There truly are many ways to treat a bunion with surgery.

After any of these procedures, the foot is wrapped in a large dressing, and the patient may be placed in a post-operative shoe and crutches. It is up to the surgeon if the patient can walk on it. It may depend on what type of procedure was done.

If needed, the surgeon may strap the toe to keep it in the correct position. The surgeon may take X-rays in the office to make sure it is still lined up properly. In the meantime, the patient will be instructed on how to slowly start moving the toe at home, so it doesn't get stiff.

The patient will start to wear their normal shoes again and will continue any physical therapy instructed by the surgeon to resume their normal daily routines.