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If medical treatment does not help to relieve pain in the toe and foot caused by a bunion, NYU Langone doctors may recommend surgery, called a bunionectomy. This procedure allows surgeons to realign the bones of the foot and remove the bony bump at the base of the big toe. The goal is to realign the foot and reduce pain. Many people are able to return to wearing standard shoes without experiencing significant symptoms.
An orthopedic surgeon may use one or a combination of techniques during bunionectomy, such as realigning the bones of the foot, removing the bunion, and cutting or “releasing” tight soft tissue structures. He or she makes this decision based on the bone structure of your foot, which is visualized using X-rays.
Bunionectomy is typically performed using local anesthesia, called a nerve block, as well as sedation. The surgeon makes an incision on the top or side of the foot to access the bunion and the joint at the base of the big toe.
During the procedure, the surgeon usually shaves down or removes the bony bump on the side of the big toe joint. He or she may also release any soft tissue structures that are too tight and pull bones out of position, contributing to the misalignment of the foot.
If changes in the bone structure of the foot are severe, the surgeon may cut the bones in order to realign them. The bones are then secured using pins, small screws, or a plate. This is called an osteotomy.
After your surgeon has corrected the alignment of the foot, he or she closes the incision with stitches.
You are discharged from the hospital on the same day as the surgery, wearing a soft cast that covers the foot and ankle. Your doctor provides you with pain medication for one or two weeks to help you recover comfortably.
Follow-up appointments are scheduled for two weeks and four weeks after surgery to monitor how the foot is healing.
Your doctor also provides you with crutches, so you can move around without putting weight on the foot. The exact type of surgery your doctor performed determines how long the cast and crutches are needed. Most people require both for at least four weeks after surgery. Your doctor removes the cast when the foot has healed enough to bear weight. This may take four weeks or longer.
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