A bunion is a deformity or bony bump that forms on the joint at the base of the big toe or hallux. Bunions may be comprised of soft tissue as well as a hard bone spur. They can be both painful and unsightly, and tend to grow worse over time. Bunions are primarily inherited, but can be inflamed and irritated when the big toe pushes against the next toe (from wearing shoes that are too narrow or tight), forcing the first metatarsal joint of the big toe to get bigger and stick out. The skin over the bunion might be red and sore. Smaller bunions (bunionettes) can develop on the joint of other toes. Stress on the foot, injuries, congenital deformities, or a medical condition such as arthritis (i.e. rheumatoid arthritis) may also cause bunions. Bunions become more common later in life, with women nine to 10 times more likely to develop bunions than men.
A bunionectomy is a surgical procedure to remove a bunion and realign the joint to relieve foot pain. There are several techniques used to repair a bunion, and often a combination of techniques is used depending on a patient's specific condition. Bunion surgery generally involves an incision in the top or side of the big toe joint and the removal or realignment of soft tissue and bone. This is done to relieve pain and restore normal alignment to the joint. If bone repositioning is needed, that part of the surgery is referred to as an osteotomy. The bone itself may need to be cut, and small wires, screws, or plates may be used to hold the bones in place.
A bunionectomy is typically a same-day surgery, taking an hour or more, and is performed under local anesthesia (less often general anesthesia). Full recovery can take weeks to months, though a patient may be able to walk on the foot immediately after the procedure. Surgery is not recommended unless nonsurgical treatment has not relieved the pain, or if a person has difficulty walking or doing normal daily activities.