What is a bunion?
Do lasers get rid of bunions?
What's unique about our approach to bunion correction?
Do bunions ever come back?
When should I have my bunions corrected?
Results of the Angulated Bunionectomy
Between Traditional and the Angulated Bunionectomy
What happens if I have arthritis in my joints?
Excellence in surgical engineering
What is my foot going to look like after surgery?
Our results speak for themselves
is a bunion?
Bunions are primarily a hereditary condition and most often progressively
become worse throughout life. They can affect anyone, although they are most
common in women. A bunion occurs due to a mechanical instability in the foot,
which results in a mal-alignment of the bones with the big toe drifting toward
the second toe. Although poorly fitting shoes do not cause bunions,
shoes can certainly aggravate an underlying condition. As a bunion
deformity progresses, we begin to notice a large bump behind the inside of the
big toe. As one walks more, the symptoms worsen. As the bunion increases
in severity, it can cause other associated foot problems, such as hammertoes,
painful calluses on the bottom of the foot and arch pain.
lasers get rid of bunions?
This much-publicized technique is often misleading. It is impossible
for a laser to cut bone or correct a bunion. Making precise bone cuts is the most critical and
important part of a successful bunionectomy. Lasers are useful for very few foot
procedures, and offer minimal benefits over traditional techniques.
unique about our approach to bunion correction?
We feel that in order to effectively correct the bunion, all of the foot
changes must be addressed to ensure appropriate function after the surgery and
to reduce recurrence. Simply removing the visible "bump of bone" will rarely
produce a long-lasting result, and does not address the internal structural
problems. Our technique includes surgical engineering to realign the bone for
proper function, and uses a surgical screw for the most stable bone alignment. The proper use of the surgical screw is technically more difficult
than other methods, but is worth the additional time and effort. Screw
fixation decreases post-operative pain, shortens the recovery time, allows for a
more rapid return to regular activities and decreases the chances for a
recurrence. If desired, the screw can be removed as a simple office procedure, a few months
after the surgery. Once the bone has healed, the screw offers no
bunions ever come back?
No surgeon can guarantee perfect results. Unfortunately, if the wrong
procedure is performed, the recurrence rate can be very high. Many of the
microsurgeries and laser techniques have a high recurrence rate because they
generally cannot accurately realign the bones.
These types of procedures have become less popular recently due to the
incidence of recurrence as well as other problems and complications.
should I have my bunions corrected?
If you have any of the following problems, your feet should be evaluated:
Calluses on the inside of the big toe
Pain around the big toe when wearing certain shoes
Painful calluses on the bottom of your feet
The big toe pushing on the second toe
Difficulty wearing shoes or participating in desired activities, such as
sports or dancing
Increasing need to wear wider shoes
the bio-engineered Angulated Bunionectomy:
In the past, bunion sufferers have been subjected to an array of surgical
procedures with mixed results. Pain, long-term disability, hospitalization and
casting were the standards of care. Now we use a procedure which
changes the traditional way in which bunions are approached. This bioengineering
technique realigns the bones and maintains the correction securely and with
generally minimal discomfort.
Bunionectomy vs. Angulated Bunionectomy
- Often done under general anesthesia, and can
require inpatient hospitalization.
- Many times requires a cast or steel rods which
protrude through the skin.
- Often minimal walking for as long as four months.
- Most patients walk immediately after surgery
without crutches, using only a surgical shoe or sandal.
- Patients cannot wear shoes for prolonged periods
if I have arthritis in my joint?
The nature of a bunion is a misaligned joint, not just a bump. As the
joint continues to function out of alignment, the bunion deformity gets worse.
Some bunion deformities worsen more rapidly than others, but they all worsen
with bunions also have osteoarthritis, or a wearing down of the joint. The
longer the joint is crooked and the longer the joint is misaligned, the greater
the chance for the person to develop arthritis.
This x-ray shows a foot with severe
arthritis of the bunion joint (1st MP joint), and less arthritis of the smaller
toe joints. Notice how enlarged the bunion joint has become enlarged due to extra
bone growth around the joint.
That is why the surgical engineering behind the
Angulated Bunionectomy is so important. The procedure is designed to restore
proper alignment and function. Traditionally, arthritic joints were destroyed
or fused. These are not good alternatives for an active person who puts
great demands on their feet. Why destroy a joint if you can save it? In
some instances, a plastic joint implant similar to a hip joint implant can be
used. The results are generally excellent for reducing joint pain and
allowing increased activity. Using surgical engineering, we are able to
get the big toe joint to bend again, saving many such arthritic joints.
The foot is a highly mechanical apparatus. Whatís surprising is how important
this joint really is. Try walking without bending your big toe, itís like trying
to drive a car with a flat tire. This is why so many people with big toe
problems have knee and back pain as well. Since the force on the big toe joint
is horizontal, bending torque moment occurs when you walk. Bending torque
moment measures the point of application of weightbearing forces times the
length of the lever arm (length of bone) to the osteotomy (bone cut). The
application of Angulated Bunionectomy (at 1/2x) minimizes the bending torque
moment. The illustration below shows the placement of the Angulated
(bone cut) as compared to other traditional osteotomies:
As the osteotomies are moved farther away from the big
toe joint, the bending torque moment becomes higher. Higher bending torque
moment creates more stress in the area of the bone cut, which can prolong
recovery time. Other bone surgeries are done similarly, but there is an
advantage in performing surgery at the end of the bone to minimize torque. This
is our special ingredient in the Angulated Bunionectomy.
Not only do we minimize torque at the end of the bone,
but the quality of the bone used is better closer to the joint. The better the
quality of bone, the faster the bone heals. Our goal in creating the
Angulated Bunionectomy was to minimize torque so that we can get you back to
your activities as quickly as possible.
The effects of bending torque moment are
similar to bending of a pencil whose point is placed on the edge of a table.
Applying a force near the tip of the pencil will not generally result in
breaking the pencil, because bending torque moment is minimized. But, if one
applies the same force near the eraser, the pencil will break much more readily.
What is my foot going to look like at the end of surgery?
While the Angulated Bunionectomy is performed to repair your painful joint,
it is also used to repair unsightly feet. Many people with bunions are
afraid to show their feet because they are embarrassed by their appearance. The
Angulated procedure has helped many people return to a life of open toed shoes.
Our results speak for themselves:
Most of our
patients experience minimum discomfort.
The Angulated Bunionectomy is done on an
outpatient basis. Traditionally, bunionectomies were done in hospitals
where patients stayed overnight, usually due to postoperative pain and their
inability to walk. Most patients stated
that their discomfort was markedly less than they had anticipated, and required
minimal medication for pain. Additionally, the surgical engineering
approach stabilizes the bone allowing our patients to walk the same day as their
The majority of
our patients are in shoes after two to three weeks.
With traditional bunion surgery, a return
to shoes has often been delayed by pain, swelling, and the inability to walk
because of pins or bone instability. The use of a surgical screw significantly
reduces pain and swelling. Security of the bone realignment usually allows
for immediate weight bearing and ambulation, without the need for casting. Patients are generally ready to begin wearing shoes two
after surgery. Traditionally pins and wires have been used to hold the
alignment of the bones. The pins stuck out of the foot and prolonged the
return to shoes by as much as a month or longer. The surgical screw we use
is placed beneath the skin and is much more stable than pins. To ensure the best
possible results, patients enter a program of vigorous rehabilitation to help
with the healing process and increase the flexibility of the corrected joint.
There is no need to be afraid of bunion
correction with our advanced techniques.
For more information about this procedure,
Time Line for Bunion Surgery
e-mail us with your questions.
Return to Foot Information