Bunionectomy Related Terms:
Bellybutton Revision, Body Contouring, Body Lift, Body Procedures, Bunion Deformity, Bunion Removal, Circumferential Body Lift, Circumferential Torsoplasty, Cosmetic Surgery, Plastic Surgery, Surgeon, Torsoplasty

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A Bunionectomy (Bunion Surgery) is a medical procedure designed to correct a bunion or a bump sticking out of the outermost portion of a toe joint (usually the big toe). A bunion is a protuberance of abnormal tissue that develops around the joint of the big or occasionally little toe. It is a symptom of faulty foot mechanics and runs in families with problematic foot types such as flat feet and low arches. Bones and tendons at the base of the big and little toe work together in a complex way to transmit and distribute our body weight. When these areas become abnormally stressed and over extended for a significant period of time a bunion deformity can develop.  Without proper healthcare and treatment, this condition can lead to chronic pain, swelling, redness, infection, pressure and discomfort when walking. Bunions tend to be inherited, but they also are commonly found in women who wear high heels, people who wear shoes that are too narrow or too pointed, having a tight Achilles tendon, and rheumatoid arthritis.

A Bunionectomy is a traditional surgical technique used to relieve persistent pain, and swelling that fails to improve or respond to medication and other non- surgical treatments. Beware of unrealistic claims that bunion surgery can give you a "perfect" foot. The goal of bunion surgery is to relieve as much pain, and correct as much deformity as is realistically possible. Unrealistic claims and expectations are a common cause of dissatisfaction with bunion surgery.

Bunionectomies are performed by orthopedic surgeons, podiatric surgeons, and general surgeons. Most bunionectomies are performed as same-day, or ambulatory surgery, in which the patient goes home the same day of the procedure. Sometimes a patient`s condition may warrant staying overnight in the hospital.

Once surgery has been decided on, the extent of the procedure will depend on the degree of deformity that has taken place. There are several different surgical techniques. The degree and angle of deformity as well as the patient`s age and physical condition play a significant role in the surgeon`s choice of technique, which will determine how much tissue is removed and whether or not bone repositioning will occur. If bone repositioning is done, that part of the surgery is referred to as an osteotomy (osteo means bone).

The type of anesthesia, whether ankle block (the most common, in which the foot is numb but the patient is awake), general, or spinal, will depend on the patient`s condition and the anticipated extent of the surgery.

Before the Buntionectomy stop smoking and get your weight down if you are overweight.  If you have heart and lung problems or blood pressure problems, ask your family doctor to check that these are under control. Check the hospital`s advice about taking the Pill or hormone replacement therapy (HRT). Check that you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first week after the operation. Bring all your tablets and medicines with you to the hospital. On the ward, you may be checked for past illnesses and may have special tests to make sure that you are well prepared and that you can have the operation as safely as possible.

There are a number of surgical methods used to deal with bunions that vary slightly according to the severity of the deformity.

For a mild bunion deformity, the Surgeon may simply remove the protrusion of bone and realign the muscle, tendons and ligaments surrounding the problematic joint.

For a moderate bunion deformity, the Surgeon may perform the above procedure in combination with an osteotomy procedure, which cuts, repositions and straightens the effected toe bone. The repositioned toe bone may be held in place with an internal screw or rod. 

For a severe bunion deformity, such as where the toe joint is diseased or damaged beyond repair, the above technique will be performed and also combined with the removal and replacement of the diseased bone with an artificial prosthesis.  

While the patient can expect to return to normal activities within six to eight weeks after the Bunionectomy surgery, the foot is at increased risk for swelling for several months. The patient is advised to keep the foot propped up and protected from pressure, weight, and injury while it heals. When the patient can expect to bear weight on the operated foot will depend on the extent of the surgery. The milder the deformity, the less tissue is removed and the sooner the return to normal activity level. During the recovery period, a special shoe, boot, or cast may be worn to accommodate the surgical bandage and to help provide stability to the foot.  Patients who are in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work. Patients should expect a continuous and full physical recovery to take up to six to nine months to achieve.
Although Bunion surgery is very regularly performed without any major complications occurring, it is very important that all candidates are fully aware of both the benefits and risks.  All surgery, no matter how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation to discuss your condition in relation to these risks cannot be over emphasized.

Complications and risks include infection (soft tissue and/or bone), scar, hematoma, nerve injury or entrapment (temporary or permanent), skin healing difficulties (wound), swelling, pain, mal-alignment, bone healing difficulties, stiffness, shortening or weakness of big toe, return of the bunion, over-correction of the bunion, prolonged recovery, blood clot in leg, blood clot traveling to lungs, catastrophic loss, pain transfer or callus formation to adjacent toes.

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It is estimated that 85% of people who have Bunionectomies are satisfied with their outcome.  Of the remaining 15%, most are improved but may still have some pain and limitations (shoe gear and/or activities).  A smaller percentage of people may experience no benefit from bunion surgery or may be worse. The bunion may re-occur if the bunion was not addressed correctly.

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