The doctor divides these methods into four categories. It is suggested to select the most appropriate surgery according to the personal foot condition.
Bunion, also known as Hallux valgus, is one of the most common foot problems. To have a surgery is the main treatment for this issue, says Dr. Bob Baravarian, the founder of University Foot and Ankle Institute. The problem of displaced intra-articular will not be recovered without the correction. Delays in treatment can cause arthritis, and the surgical method will then be different. There are 44 methods to perform the surgery, and they can be divided into four main categories. The most appropriate surgical approach should be selected based on the personal foot status. Besides, it is very important to have physical therapy rehabilitation after the surgery in order to recover normal activity at the wound.
The most commonly performed bunion surgery is called Heads procedure. An osteotomy, or bone cut, is made on the metatarsal head, just behind the big toe joint. The length of the osteotomy increases when the hallux valgus angle increases. It can also be divided into the most traditional Austin Bunionectomy and the Offset V Bunionectomy. 75-80% of the patients accepted the Austin Bunionectomy as the success rate is high. The Offset V Bunionectomy on the other hand has a longer cut, and the bones are held by two cortical screws. This helps bones better rotary. In the past, the bones were not held by screws; therefore, the osteotomy made both side of bones rub each other and resulted severe pains. To hold the bones by screws reduces swelling, and the patients are able to put weight on their foot sooner.
It is common to perform the Offset V Bunionectomy for the patient, who is under 50 years old with mild to moderate bunion. The patient should be able to bear weight with the aid of a protective boot immediately after the bunionectomy. The patient should wear the boots for 5-6 weeks, start rehabilitation two weeks after the bunionectomy. The patient should be able to wear the normal shoes 8 weeks after the bunionectomy and recover completely in 3 months. Depending on the individual’s ankle tightness, the bunion may come back. However, since the problem has been corrected, which increase 80% of the foot stabilization. Therefore, the problems will not recur for most of the patients. Even if the bunion comes back, the situation would not be as serious as before. After the osteotomy is healed, the foot condition should return to be regular.
Scarf Osteotomy is also one of the common treatments. Dr. Baravarian says that scarf cut is the most stable method for a carpenter. The doctor operates Z osteotomy cuts on the first metatarsal in order to adjust the bone’s ankle and then held the bone with two screws. The patient should be able to recover quickly as the cut is long and the base of the metatarsal is hard. When the Heads Procedure is not suitable for the patient, Scarf Osteotomy then becomes the other good choice for a severe bunion treatment.
Lapidus Bunionectomy is another surgery, also called as the Golden Standard bunionectomy that can correct the metatarsal back to the regular position. It will take a longer recovery period with the greatest result. Dr. Baravarian says that the joint below the first metatarsal is non-critical joint that does not affect the regular walking. Therefore, Laidus Bunionectomy starts with the cut on the instep, and then removes the joint under the metatarsal, which allows more space to place the first metatarsal back to the proper position, and then holds the bone in the position with two screws or a flat board.
Since Lapidus Bunionectomy directly fixed the joint that caused the bunion, the problem will not came back again. More and more patients use this bunionectomy to fix the problem. It is suitable to patients with moderate to severe bunion, or patients with excessive joint laxity. Besides, the new technologies that infuse spinal cord stem cell concentrate during bunion surgery speed up the recovery time.