What's a bunion?
Basically a bunion is a bump. Usually it is
at the base of the big toe. (But there is a tailors bunion at the side of the
of the little toe.) The bump is made of bone. There are basically three types
The simple bunion
This is an enlargement of the head of the first metatarsal. Sometimes referred
to as a calcium deposit. This type can usually be 'fixed' in the office with
minimal incision surgery MIS. MIS is sometimes called "microsurgery" because it
is done through very small incisions. There is no pain during surgery, because
the foot is put to sleep with local anesthetic similar to the dentist's novacain.
Then the bump is simply smoothed off. A couple of stitches are applied and you
walk home with a cute post-op shoe. Healing is usually quick and relatively
pain free due to the little trauma involved in this type of surgery. You might
get back into shoes in two - three weeks.
The mild to moderate bunion
This involves more than just a bump of
bone. When a simple bunion is neglected it usually
worsens to this stage. The bone structure changes. The big toe begins to drift
toward the little toe side of the foot. Like the leaning tower of pisa. The
first metatarsal begins to spread away from the rest of the foot making the bump
look much bigger. Sometime MIS can still be used in the office to 'fix' these
deformities. Surgery is a little more involved because bones must be cut
and realigned in a straighter position. A cast or metal pin may be used to hold
the foot straight while it heals. Plan on four to six weeks before getting into
The severe bunion
When the bones in the foot have spread apart too much, I must open the skin and
reposition one or more bones. Because this involves a relatively large incision
and a great deal of change to the bone structure I will always recommend having
the surgery in the hospital. This is done out patient. You come in the morning
and can leave in the afternoon. You will have a cast and you will use crutches
for about a month to eight weeks. Back in your shoes in eight to twelve weeks.
The hospitals I use are Staten Island University and Raritan Bay
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