BUNIONECTOMY : A bunionectomy is a surgical procedure to excise, or remove, a bunion. A bunion is an enlargement of the joint at the base of the big toe and is comprised of bone and soft tissue. It is usually a result of inflammation and irritation from poorly fitting (narrow and tight) shoes in conjunction with an overly mobile first metatarsal joint and over-pronation of the foot.
The intense pain of a bunion makes walking and other activities extremely difficult. Since the involved joint is a significant structure in providing weight-bearing stability, walking on the foot while trying to avoid putting pressure on the painful area can create an unstable gait.
A bunionectomy is performed when conservative means of addressing the problem, including properly fitting, wide-toed shoes, a padded cushion against the joint, orthotics, and anti-inflammatory medication, are unsuccessful. As the big toe moves sideways, it can push the second toe sideways as well. This can result in extreme deformity of the foot, and the patient may complain not only of significant pain, but of an inability to find shoes that fit.
In a bunionectomy, an incision is made over the swollen area at the first joint of the big toe and the enlarged lump is removed. A repositioning of the alignment of the bones of the big toe might also be required. If the joint surfaces have been damaged, the bones are held together with screws, wires, or metal plates. In severe cases, the entire joint may need to be removed and a joint replacement inserted.
