Many patients try a variety of conservative treatments to tolerate their bunions and to avoid surgery as long as possible. Unfortunately, when conservative care stops working and severe pain and swelling begin to interfere with daily activities, they find themselves at a crossroad. This is when the realization sinks in that the time has come to consider bunion surgery. Many of them are at a point where they want surgery sooner than later but they are still confused and anxious. Many even avoid surgery because misconceptions guide their decision. Here are the common questions that I discuss with my patients that hopefully will help you decide if you are ready for bunion surgery.
When is surgery needed?: When the pain of a bunion interferes with daily activity, it is time to discuss surgical options with your podiatrist or orthopaedic physician. Both of you can decide if surgery is necessary and what procedures are best suited for you. The overall goals of surgery are to relieve pain, to remove the bunion and keep it from returning, and to correct the alignment and mechanics of the foot.
Are there different surgical procedures?: A bunion is more complicated than a bump on the side of the big toe. The type of procedure performed depends on the severity of the bunion and a combination of factors such as age, activity level, health, and condition of bones, muscles, tendons, and ligaments in the foot. Various procedures are used to correct mild, moderate, severe, and arthritic bunions or big toe joints. Your surgeon will select the best procedure for your condition.
What are the risks?: The vast majority of patients do not experience complications from surgery; however, it is a good idea to review all the pros and cons of surgery with your surgeon a well as the consequences of delaying or not having surgery. Possible complications may include a recurrence of the bunion, continued pain, an overcorrection of the problem, nerve damage, stiffness, swelling, numbness, infection, length of time for healing and recovery, restricted motion and flexibility in the toe joint, and arthritis.
Will the bunion come back?: Recurrence is possible but not likely if the correct procedure is tailored to resolve the severity of your bunion; and if proper shoes are worn following surgery.
Will I have unsightly scars?: Your surgeon may be able to minimize the incision by using alternate surgical approaches and closure techniques. Laser technology is also available to reduce scars post-operatively. The majority of patients are satisfied with their outcome.
What can I expect after surgery?: The length of the recovery period varies depending on the procedure performed. It is important to comply with instructions for dressing care, bearing weight, swelling and shoe wear, exercises and therapy, and medications. Most activities may be resumed within six to eight weeks, but it may take six months for full recovery. Most patients experience a significant reduction of pain and improved alignment of the big toe. Patients will have driving restrictions if the right foot is repaired. Patients will have shoe restrictions for life to reduce the chances of a recurrence.
What are the keys to success?: Selecting the right surgeon is critical to ensure a good outcome. When selecting a surgeon, ask about his/her medical school education, accredited residency training, board certifications, areas of practice specialization, and experience in performing bunion surgery. Ask your surgeon to explain all the pros and cons of the surgery and to disclose all of the potential problems and realistic expectations. Remember, not all surgeons are created equal so be careful in choosing the right physician. Choose a surgeon you can trust. Be wary of a surgeon who makes assertions that his/her procedures are superior, minimally invasive, and virtually pain free. Other red herrings become apparent when a surgeon guarantees a bunion will never return, patients never need crutches, or that your bunion is going to get worse if you do not have surgery as soon as possible. Credible surgeons will give you realistic expectations and possible complications.
If you are looking for a board certified foot and ankle surgeon or want additional information, regarding bunion surgery or laser technology scar remodeling and pain therapy, contact John Sigle, DPM, FACFAS at the Foot & Ankle Center of Illinois at (217) 787-2700. The Foot & Ankle Center of Illinois is located at 2921 Montvale Drive, Springfield, IL, and at St. Mary’s Hospital, 1900 East Lake Shore Drive, Decatur, IL. Visit myfootandanklecenter.com to view brochures on the treatment of bunions.