By Jayne Rutledge


A bunion is an often painful protrusion on the joint of the big toe which results when the angle of the toe is shifted inwards too much. The most common cause of this disorder is wearing tight-fitting shoes that place the toes in an abnormal position, leading to the misplacement of this joint which in turn can cause pain and make standing for long periods of time unbearable. There is an operation which can be effective, however it is advisable that before bunion surgery San Francisco patients learn what it entails.

If this condition is caught early, it may be reversed using a splint or brace and the discomfort may be lessened with corn pads, although these measures usually only provide temporary relief. Some types of specially made footwear can also help accommodate this anomaly or arch supports can also be helpful if the problem is caused by fallen arches.

Those bunions which are more severe can only be remedied by a surgical procedure. If a patient has not responded well to non-operative measures and is considerably afflicted with pain, surgery is indicated. The operation is performed while the patient is given a combination of local and general anesthetic, with more of the former used so less of the latter is needed. It is often done as an out-patient procedure, but sometimes an overnight stay is necessary.

The proper name for the procedure is an "osteotomy". The bone of the big toe, called the metatarsal bone is divided and put back into its normal position and the bony protrusion is trimmed away. Strength is restored to the large toe and the upper foot is effectively narrowed. The bones will be held together with surgical screws or staples until it heals fully and a special type of post-operative shoe is worn to protect it.

After the procedure, it is normal for the foot to be swollen and painful under its bandages. Medications can help control the pain and elevating the foot to heart level can ease the swelling. It is important to wear the post-op shoe continuously, even when sleeping. Two weeks later, stitches can be removed, and exercising the toe regularly starting with immediately after surgery can help prevent stiffness.

Patients must wear the post-op shoe for about six weeks, and then they can switch to an open-toed sandal with straps that can be adjusted. After another six to eight weeks, regular shoes can be worn and once three to six months have passed, sporting activities may be resumed.

Overall, there is a marked improvement in most patients. Very rarely a complication may occur such as skin infection, blood clot, toe sensitization, stiffness, problems with surgical screws, non-healing of the bone, or a problem with weight being transferred to the second toe and a corn forming on it as a result. These incidents are very uncommon though, and most people enjoy good results.

Prior to deciding in favor of bunion surgery San Francisco patients need to be aware that this procedure is one intended for those who are bothered by persistent pain that cannot be alleviated any other way. It isn't generally performed to simply prevent symptoms from worsening or for cosmetic reasons.




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