A definition of Bunionectomy (removal of growth on toe)
Often resulting in an enlargement of the main joint of the big toe, a bunion is comprised of both bone and soft tissue. A bunionectomy is the surgical procedure to remove a bunion. After surgery, the patient will have lost range of motion in the big toe due to a shortening of the soft tissue. In order to regain movement of the toe a patient may need to wear a dynamic splint in order to provide a gradual and constant stretch to the soft tissue. After the patient is fit with extension and flexion Dynasplint® Systems, in about 2-3 months, the toe’s connective tissue will be lengthened and a patient will be able to return to normal daily activities and footwear. If you have had a bunionectomy, wearing a toe rehabilitation device like the Dynasplint® System can speed up your bunionectomy recovery process and restore your range of motion in the big toe.
Many bunions can be resolved through non-surgical bunion treatment, but some patients will need to undergo surgery to find relief from the pain and discomfort that bunions can cause.
Bunionectomy is usually recommended in patients who meet at least one of the following criteria:
- Severe pain in the affected foot which may limit both mobility and the type of footwear that can be comfortably worn
- Chronic inflammation and swelling of the big toe that does not resolve with rest or medication or a change in footwear
- Inability to straighten the big toe
- Drifting of the big toe toward the smaller toes
Bunion surgery is designed to help correct the pain and deformity that may be present, however, cosmetic surgical procedures are becoming more common. Joint realignment may also be a part of any surgical intervention. Several types of bunion surgery are available, including:
- Osteotomy. This procedure involves cutting the bone and realigning the joint to a more normal position.
- Tendon and ligament repair. In some patients, deformity of the big toe may occur when the tension of tendons and ligaments attached to the toe is unequal, causing more pressure to be exerted on one side of the toe joint than on the other. This inequality can cause the toe to become misshapen, and repairing these ligaments to balance pressure and tension can help remove the bunion deformity and eliminate pain. This procedure may be combined with an osteotomy.
- Arthrodesis. In arthrodesis, the damaged joint surfaces are removed and screws, wires or plates are used to hold joints together during healing. This procedure is generally reserved for patients with severe bunions or arthritis, or when other procedures have not succeeded.
- Resection arthroplasty. In a resection arthroplasty, the damaged portion of the joint is removed or “resected.” Usually, this procedure is reserved for patients with arthritis, those who are older, and those who have had previous surgery to correct the bunion.
Most patients report a dramatic improvement in pain levels and joint alignment in the big toe following bunion surgery.
After surgery, and for the weeks during the healing process, the treating physician will monitor the toe to ensure the joint is healing properly. Immediately after surgery, a surgical shoe or air cast will be worn for a minimum of two weeks. Once surgical sutures are removed, a brace or splint will be prescribed to help keep the toe in proper alignment while it heals.
Upon completion of the surgical procedure, most patients will need to manipulate their toe or use dynamic splinting to help regain range of motion for ambulation without pain. Some patients may need to undergo physical therapy in conjunction with dynamic splinting to regain full range of motion and strength.