When is surgery indicated for the bunion?

When is surgery indicated for the bunion? Is the most common question asked? Surgical referrals should only be made when conservative approaches have failed.

This introductory article covers some important indications for managing the bunion. Conservative care aims to address three elements. These elements include alignment (A), the deformed part of the bunion, the integrity of tissue (I), and pain as in discomfort (D). Pain may come from the skin. 

Each of these three elements will influence how we walk. The importance of how easily we find movement comes under the term mobility (M).  These elements can be referred to as A.I.D

When you might be referred for Bunion Surgery

The following considerations will represent the standard questions that a professional might consider when discussing surgery with you.

Where mobility (M) is reduced, this will limit our capacity to enjoy walking and other activities. Foot discomfort (D) caused by everyday shoes not fitting because of our foot’s alignment adds to the problem. Footwear education should be provided. This comprises checking our shoes for fit, design, and suitability. So often, old shoes are not replaced because they become old faithful.

Discomfort (D) levels of pain are assessed between 0 and 10. Once the pain scales to 3 upwards, then clearly, matters need investigating. Ask yourself what level of pain or discomfort you experience. How long does this pain last? Do you need to take medication for pain?

 

Secondary features affect each of the three components of alignment: the integrity of tissue and discomfort (A.I.D). A secondary feature means that the primary problem (the bunion) may well be causing additional foot deformities, such as toe buckling (hammertoes), or skin problems, such as corns between the toes. Irreversible tissue concerns (I) may be associated with medical factors, such as nerve sensory reduction associated with diabetes. Where conservative methods, including the use of orthoses, splints, and taping, fail to assist with (A) alignment, surgery may be an option. Problems higher in the leg and body can be associated with poor alignment, causing pain in the knee, hip, and back. Podiatrists can assess your walking ability.

Surgery should achieve all aims of A.I.D

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All in one place

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Click here & on ‘NEW BOOK‘

 

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Cautions & Risks

Do not have surgery to look better for cosmetic reasons, and do not have surgery to embark on fashion statements. Be careful not to have surgery just because a parent or grandparent had the problem. Take your time and seek advice from a professional. A bullet-point summary is listed below, but it is not exhaustive.

If you do have surgery, here are some of the aspects you need to be aware of:

• Reoccurrence of the deformity in 7-15% of bunion operations
• Failure to achieve what you want or need in 10-15% of cases
• Stiffness in the big toe can be permanent
• You may be limited to shoes after surgery
• Increased pain can arise from scars, trapped nerves and transfer pain across the ball of the foot, also known as metatarsalgia

Do I need bunion surgery?

This has been a quick reference article for surgical referral for both the professional and lay reader. The content may be useful when patients consult their foot health professionals. You may also like to read my article on Bunion surgery: When is the best age? You can also read what a podiatric surgeon (UK) is on this site. Another useful fact sheet covering surgery on the bunion can be downloaded, showing risks and outcomes. 

 

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Thank you for reading “When is surgery indicated for the bunion”  by David R Tollafield 

Updated December 2024 

Published by Busypencilcase Communications. Est. 2015 for ConsultingFootPain