Avoid Putting Off Bunion Surgery If Possible

PINE GROVE, Pa. — Immediately after emerging from bunion surgery, meeting new people isn’t atop most patients’ list.

And it wouldn’t seem like wearing a surgical boot, which one does continually for about six weeks and transitionally afterward, could be a good way to meet people.

But it can be.

A common first question is: “Is that from a skiing accident?”

Whether that means water or snow, the question is a good one.

And when the answer includes bunion surgery, one often hears of others’ similar challenges.

Bunions are often inherited conditions.

A bunion can look like an overgrowth of bone in the joint at the base of the big toe.

But that’s not what it is.

And it’s not the joint at the base of the big toe that causes the bunion.

The cause is in the middle of the foot.

Metatarsals are bones extending from the base of the toes to the middle of the feet.

The largest metatarsal extends from the base of the big toe.

At the end of that metatarsal in the middle of the foot is another joint. When that joint functions properly, the metatarsal should stay in line toward the big toe, no bunion should form, and the big toe can look normal and function normally.

A defect in that joint can destabilize it, preventing it from holding the metatarsal in line. The metatarsal can then move. Although that can happen in any combination of directions, it often shifts out.

When it shifts out, it can push the joint at the base of the big toe out and then push the big toe in, toward the other toes.

Sometimes bunions hurt, and sometimes they don’t. With more serious bunions, walking can hurt and become difficult.

Bunions can also cause other problems.

They’re unlikely to improve on their own.

The longer one waits to address a bunion, the worse it can get and the tougher the recovery can be, particularly with age.

So if it’s possible, it’s good to avoid putting off bunion surgery.

One way — an old way — of addressing a bunion was to shave off what appears to be the overgrowth of bone on the joint at the base of the big toe.

However, that can be analogous to taking an over-the-counter pain killer for an ordinary headache: It can mask the symptoms without fixing the root cause of the problem.

Just as the headache can return when the pain killer wears off, the bunion can return if the metatarsal shifts out of line again or shifts farther out of line.

A new procedure — which goes by the trademarked name “Lapiplasty” — can fix the root cause of the problem by stabilizing the joint in the middle of the foot.

During surgery, two titanium plates are permanently attached to the bone to stabilize the defective joint, one on top of the foot and one on the side. Each plate is a few inches long, very narrow, and flat.

The first few days after surgery can be the toughest, and walking can require crutches or something similar.

The full course of the recovery varies with each person and can take months, perhaps many months.

In this patient’s experience, if scar tissue develops inside the foot, one can break it up over extended time with lotion and two vigorous thumbs. It’s a little like pushing toothpaste out of a tube.

One prospective bunion-surgery patient said to this patient, “I’m afraid it will hurt.”

Yes, it will hurt.

Yet it can hurt less than a bunion, and one can look forward to walking well and comfortably again.

Randy Elf has had two bunion surgeries, one in 2019 and one in 2020.



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