Innovative, minimally invasive bunion procedure enabling swift recovery while maintaining walking ability. A bunion, also known as hallux abductovalgus, is a condition marked by a protruding bump at the base of the big toe on the inner side of the foot. This prominence arises from changes in foot alignment, causing the big toe to shift towards the smaller toes. Discomfort can emerge due to pressure from the bump against footwear or due to friction between the big toe and the second toe. Additionally, the misalignment of the big toe might lead to discomfort in the ball of the foot and arthritis of the big toe joint in the future.
Can bunions be addressed without resorting to surgery?
Conservative, nonsurgical treatments for bunions involve wearing spacious, soft shoes, using "bunion pads" or toe separators, and taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. While toe separators and devices that separate the big toe from the second toe might alleviate pain, they don't eliminate the bunion deformity. Surgical intervention is necessary to correct toe alignment.
Who is a candidate for bunion surgery?
Bunion removal surgery should not be pursued solely for cosmetic purposes. It's recommended for individuals whose daily lives are impacted by persistent pain and discomfort, even after trying more accommodating footwear.
If you've attempted wearing wider shoes, using padding, or other remedies, yet still experience pain that curbs your activity, you might be eligible for corrective bunion surgery.
What does bunion correction surgery involve?
The corrective procedure for bunions, known as metatarsal osteotomy or bunionectomy, involves various techniques, all entailing bone cuts and realignment using metal screws to straighten the big toe and alleviate the foot's protrusion.
Historically, traditional bunion surgery could be quite painful and entail an extended recovery period due to significant incisions. In contrast, modern minimally invasive method offer considerable advantages. Here at Park Avenue Medicine & Surgery, I perform the specialized minimally invasive technique to rectify bunions through 3 to 4 tiny portals which leave minimal to no visible scarring. The technique effectively addresses a wide range of bunion deformities, spanning from mild to moderate and even severe bunion cases.
How does minimally invasive bunion surgery function?
Minimally invasive bunion surgery employs a burr, rather than a saw, to make bone cuts. This approach allows "percutaneous" cuts through tiny incisions in the foot's skin, in contrast to the more extensive incisions in conventional methods. By avoiding large incisions, fewer soft tissues (skin, muscle, joint capsule, etc.) are disrupted, leading to reduced post-surgery swelling and discomfort. This facilitates immediate weight-bearing, accelerates bone healing, and hastens the return to regular activities. Unlike traditional methods, I use a burr and small incisions for this correction, allowing for immediate weight-bearing, less pain, improved aesthetics, and faster return to work and sports.
What are the advantages of minimally invasive versus open bunion surgery?
Minimally invasive bunionectomy offers less pain, quicker recovery, and better cosmetic outcomes due to smaller incisions.
Conventional open bunion surgery necessitates a larger incision encompassing the entire big toe joint, resulting in a substantial scar. This approach can contribute to the formation of scar tissue within the joint, potentially leading to joint stiffness. Furthermore, the increased size of the skin incision elevates the likelihood of complications, including infection and structural issues.
I've observed that patients undergoing the minimally invasive technique require less pain medication, have better range of motion in their big toe, and transition back to regular footwear in half the time compared to those undergoing open surgery.
Do you need avoid weight-bearing after bunion surgery?
Owing to the robust and secure anchoring of the screw fixation and employing a specialized bone cut technique, patients can engage in immediate ambulation following minimally invasive bunion surgery while wearing a designated post-operative shoe. While immediate walking is feasible, it is recommended to minimize weight-bearing and rest during the initial two-week phase to reduce post-surgical swelling. Typically, during the first week, you should keep the operated area elevated around 80% of the time, reducing it to 50% during the second week. Most patients take at least two weeks off work, with longer duration if commuting is necessary.
What's the recovery timeline for bunion surgery?
Full recovery duration hinges on whether minimally invasive or open surgery was performed. Generally, patients who underwent minimally invasive bunion surgery can begin walking in regular sneakers approximately six weeks after the surgery (in contrast to 10 to 12 weeks after open surgery). Subsequent activities can be gradually increased based on patient tolerance. Running and jumping restrictions last for 12 weeks, while activities like biking, spinning, walking, and swimming can be resumed as tolerated.
Recovery from minimally invasive bunion surgery
Post minimally invasive bunion surgery, you'll wear a specialized surgical post-op shoe and can bear full weight once sensation in the foot has returned. For the first two weeks, activity should be limited, and the foot should be elevated 50% to 80% of the time to minimize swelling and support wound healing.
After the initial two weeks, a bunion splint might be provided to maintain post-surgical alignment. During this period, walking can gradually increase, and normal daily activities can be resumed.
When can normal shoes be worn after minimally invasive bunion surgery?
The special post-op shoe is worn for approximately six weeks after surgery. Typically, transitioning to regular sneakers is possible around six weeks, depending on swelling and comfort levels. Most patients can wear flat, comfortable shoes and all types of sneakers and boots around three months post-surgery. Some degree of swelling might persist for 6 to 12 months, possibly affecting the choice of high-fashion shoes. This timeline can be extended if additional foot surgeries, such as hammertoe corrections, were performed. Generally, regular sneakers can be worn about 10 to 12 weeks post-surgery, and activity can be increased based on tolerance.
How effective are bunion surgeries, and what are the risks?
The majority of patients report high level of satisfaction with their minimally invasive bunion surgery outcomes. Favorable results are achieved if postoperative instructions are followed closely. Risks do exist, including delayed bone healing, although this is uncommon. The risk increases if patients engage in excessive activity too soon against medical advice or have underlying health conditions affecting bone healing. Temporary numbness around incision sites might occur, usually resolving in three to six months, though rare cases of persistence exist. Complications like bleeding, blood clots, and anesthesia-related risks are also infrequent. Bunion recurrence after minimally invasive bunion surgery is exceedingly rare. This can be attributed to the sturdy and secure hardware fixation and specialized bone cut technique employed.