Bunion Surgery

What is a bunion? 

A bunion is a bony protrusion located at the base of the big toe. This is actually not a new bone growth, but rather just the bone that is slowly being pushed outwards due to weak structures in the foot or abnormal foot mechanics.

How do you treat bunions?

The only treatment for bunions is through surgery. Bunion surgery usually involves realigning the first metatarsal so that the joint no longer deviates. This is done by applying local anesthetic to numb the affected foot. In some cases, a sedative may be used to calm the patient. The surgery usually lasts an hour or so and is commonly done on an outpatient basis. The aim of bunion surgery is to restore the normal alignment of the joints and eliminate pain. 

What are the major types of bunion surgery? Types of bunion surgery

1. Traditional Bunion Surgery

Traditional or Typical bunion surgery is done by making an incision, around 5 to 7 cm, to expose the bulging bone. Then a part of the metatarsal head is removed. This process is called bunionectomy or exostetomy. The bones are then positioned and pinned in place and excess bone is removed. In this type of bunion surgery, expect swelling and pain after surgery. It takes about 6 to 8 weeks for recovery to occur, during which time, crutches are required when moving around.

Minimally Invasive Bunion Surgery

This is a new bunion surgery technique, also called no scar bunion surgery or scarless bunionectomy, is less invasive compared to the traditional type of surgery. This involves a very small incision, around 5mm or less. Then a live x-ray is used to help the surgeon locate the best place to cut the metatarsal bone. After cutting, the bone is repositioned to its adjacent metatarsal bones to get the foot as normal as possible. Once the bone is realigned to its ideal location, a pin is inserted to immobilize the bone and the incision is closed. Minimally invasive bunion surgery is virtually painless and the procedure is done as an outpatient basis. There is very little to no pain after surgery, and recovery time is only about 2 to 3 days.

Common Causes of Heel Pain

Heel pain is a very common condition. About 70% of Americans are not able to do much activities or exercise simply because of heel pain.  There are two kinds of pain associated with the heel. Posterior heel pain or pain behind the heel, which involves the attachment of Achilles tendon to the heel bone. Inferior heel pain or pain underneath the foot is caused by an inflammation or irritation of the plantar fascia.

There are several causes of heel pain:

Achilles tendinitis

Bone bruise

Bone cyst

Bone fracture

Bone spurs

Bursitis

Gait problems

Gouty arthritis

Heel pad wear and tear

Neuroma

Osteomyelitis

Peripheral neuropathy

Pinched nerve

Plantar fasciitis

Rupture of the Achilles tendon

Rheumatoid arthritis

Stress fractures

Tarsal tunnel syndrome

Tendinitis

Of all the causes of heel pain, plantar fasciitis and Achilles tendinitis are the most common.

Plantar fasciitis is the inflammation or irritation of the plantar fascia. The plantar fascia is a strong fibrous tissue that inserts at the heel bone and to the toes of the foot. It plays an important role in the biomechanics of the foot because it is responsible for maintaining the arch of the foot.

The plantar fascia can get irritated because of overuse. Usually, patients involved in sports or those who are overweight are affected because of the increased amount of stress on the plantar fascia. It is also prone to degenerative process of aging. The older we get, the weaker the fascia.

The Achilles tendon is a strong fibrous tissue that also attaches to the heel bone. Unfortunately, this too is prone to irritation and inflammation because of overuse. This condition is called Achilles tendinitis. Achilles tendinitis is more of a sports injury seen in runners, basketball players, and volleyball players and people involved in any sports that would cause strain on the tendon and calf muscles.

Resting the foot and allowing it to heal is the best treatment for both conditions. But if foot pain is ignored, which most patients commonly do, it can lead to chronic heel pain, where more complicated treatment modalities are needed.

If you have any question about heel pain or any other foot and leg condition please visit the Family Foot and Leg Center in Naples, FL or contact Dr. Kevin Lam at (239) 430-3668 for more details.

Big Toe Pain

Seemingly every year, there are more and more patients with lingering foot pain and difficulty in walking. This can be caused by the great toe joint. Some patients may think that bunions are the only thing that can cause this pain, but truly this is only part of the story. A number of studies in recent years show the natural progression of arthritis in toe joints which do not seem to have any bunion characteristics, such as prominent bone on the inside of the foot and deviation of the great toe towards the lesser toes. This can be related in most cases to a distant trauma which occurred an unknown time ago.

At FFLC, there are several pain management modalities to provide nonsurgical relief in this area, ranging from orthotics and cortisone injections, to the new Cold LASER therapy for recurrent pain which can reduce symptoms in chronic pain of arthritis significantly without medications.

Something as trivial as stubbing your toe, or landing abruptly and resultant pain in the bottom of the joint that seems to go away, may eventually return later on as a limitation in joint motion, and pain in the foot which is related to the adaptive and erosive side effects from "hallux rigidus". This is visible after age 50 and can affect men and women, and can be the major source of a significant amount of discomfort and limitation with walking.

At The Family Foot and Leg Center, numerous conventional and proven treatment protocols for patients are available to give you the best chance at pain free ambulation. If you have arthritic changes on a regular X-ray, and the deformity is not too severe, you may even qualify for the latest implant arthroplasty technique known as "joint resurfacing". This is a relatively advanced joint replacement which allows patients to walk immediately after the surgery, and there are no weight bearing restrictions with a very high success rate both in the short term and long term.

Not everyone is a candidate, but for those who experience such pain, will acquire immediate relief. After several weeks post operatively, your range of motion should be close to the other foot, and in most cases significantly increased from before the procedure is done. It is an outpatient procedure with strict criteria prior to undergoing this advanced modality. Numerous other therapies for other conditions of the foot and ankle are available, check out Family Foot and Leg Center and Naples Heel Pain for the latest in the care
of your foot and ankle conditions.