There are two ways a podiatrist selects which procedure is best suited for you. First, they will give you a clinical exam, which shows the range of motion available, the pain experienced with motion and footwear, and the mobility of the big toe and associated joints. Then, they will look at your x-rays. From this they will see the positive or negative findings of arthritic change due to joint cartilage and bone, the angle between the big toe and the second toe, and finally the length and position of the big toe.
Most procedures will include a "bumpectomy", which shaves off the part of the bone that is sticking out beyond the natural line of your foot. Inner muscles of the great toe may also be cut to prevent the big toe from crossing over to the second toe.
In a situation where the joint is severely arthritic and painful, one of the joint resection procedures would be the best option for you. Joint replacement is an implant that allows for minimal and pain-free motion. Joint fusion is a fusion of the metatarsal bone and the big toe. Joint resection procedures greatly reduce and even eliminate the pain associated with the bunion, but can also greatly decrease the range of motion.
For those who have a mild to moderate bunion, with a slight angle between the first and second toes, the surgical procedure usually involves moving the head of the metatarsal inward by making a sideways triangular cut called an Austin, or modified Austin. Once the cut has been made, the first toe is moved back towards the second toe and fixated. The benefits of this procedure is that there is a faster recovery time, easier healing, and the correction is very stable. The downside is that this procedure is only for mild to moderate bunions.
Moderate bunion procedures involve the shaft of the metatarsal. If the angle of the metatarsal is too great for a head procedure, meaning that the head could not be moved over for correction and be considered stable, then your podiatrist will instead make a cut in the shaft of the metatarsal, allowing for less movement and more correction. The benefit of having this procedure done is the angle of your big toe will be closer to what it used to be and the base of the toe will likely be hypermobile. Cons include a longer recovery, less stability, and a greater surgical expertise.
A base procedure is done when there is a very high angle between the first and second metatarsal. A metatarsal base procedure allows for slight movement inwards and great angle correction.
If you are suffering from a bunion, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
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