Correcting a Failed Bunion Surgery

Carmerlla discusses her bunion revision surgery at UFAI and how it changed her life.

We understand that revision surgery is complicated, both medically and emotionally. The pain and wasted time and money resulting from a failed bunion surgery can be devastating for patients.

 

At UFAI, we see a lot of failed bunion surgeries. In fact, correcting failed bunion surgeries accounts for about 30% of what we do. Bunion revision is really a completely different type of surgery than primary bunion correction; one that requires much more skill to do successfully.

With us, you are in good hands. Our surgeons are among the most experienced and sought-after bunion revision surgeons in the country.

What is a Failed Bunion Surgery?

Bunion correction surgery is a difficult solution to a complex problem. Most bunions have several interacting causes, and surgical correction is rarely the quick fix that some doctors make it out to be.

 

When a bunion returns after surgery, or when additional problems develop, this is what we call a failed bunion surgery. Bunion surgeries may fail for a variety of reasons, but most often the problem can be traced back to an inappropriate “one size fits all” surgical approach.

 

Bunions are as unique as the person who suffers from them, and there are at least 44 different types of bunion surgeries currently in use to correct them. A surgeon with a wide range of expertise and years of experience will be able to customize your procedure to successfully treat your bunion.

 

How Can Bunion Correction Surgery Fail?

 There are several ways that primary bunion correction can fail.

  • The bunion comes back (Recurring Bunion)
  • Excessively short big toe
  • The big toe develops structural problems (Hallux Varus)
  • Severe stiffness in the big toe joint
  • Arthritis of the big toe joint (Hallux Limitus)

 

Patient non-adherence can sometimes play a role in a failed surgical outcome. But usually, when bunion correction fails, it’s because the surgery never addressed the underlying problems that caused the bunion in the first place. The surgeon didn’t choose the right procedure to correct the deformity.

 

If you’ve recently had bunion correction surgery and developed any of these issues, please give us a call. Our nationally-renowned surgeons can evaluate your condition and set you up with an individualized plan to fit your unique needs.

 

What Can UFAI Do to Correct a Failed Bunion Surgery?

That depends on your particular complications. Read on to learn more about what UFAI surgeons can do for you.

 

Recurring Bunion

If the bunion returns after surgical correction, most often the underlying problem wasn’t address in the initial surgery and the deformity was never really corrected. This may in part be due to the surgeon choosing a procedure that was inadequate to correct the deformity. At UFAI, we are one of the few clinics in the nation experienced with all 44 types of bunion surgery which gives us the ability to truly customize each bunion surgery for each patient.

 

To correct a recurring bunion, the surgeon must surgically align the displaced foot bones into their proper position. Excessive motion in the foot bones causes the bones to spread apart and the bunion to redevelop. This can be resolved with an osteotomy (a bone cut) or with fusion (bone mending).

 

Most often, we recommend a Forever Bunionectomy to correct a recurring bunion. This bone-mending procedure accomplishes two things:

  • It properly realigns the bone, and
  • Directly treats excessive motion, so the bones can stay in place.

 

Excessively Short Big Toe

Any bunion surgery that involves bone cutting or fusion will result in a shortening of the big toe, but the big toe should not shrink so much as to cause you pain or impact your foot’s ability to function.

 

Shortening becomes a problem when it affects the ball of the foot, the functioning of the big toe joint, or the relationship of the big toe joint to the rest of the foot.

 

To correct an excessively shortened toe, the surgeon will likely reverse the initial surgery and develop a personalized plan to regain length. This could involve:

  • Special lengthening bone cuts
  • Bone grafts
  • Bone fusion, or
  • Growing new bone tissue

 

New Structural Problems in the Big Toe (Hallux Varus)

Hallux Varus, Bunion Revision Surgery, University Foot and Ankle Insitute
This "after" picture was taken just six weeks following surgery.

The medical term for your big toe is “hallux.” Hallux Varus refers to a structural problem where the big toe drifts away from the lesser toes, which can be painful and make it nearly impossible to wear regular shoes.

 

Hallux Varus is caused by a muscular imbalance resulting from a failed bunion surgery. The big toe is pulled in the wrong direction, possibly due to any of these problems with the surgery:

  • Too much bone was shaved away from the bunion.
  • The sesamoid – a critically important, but small, foot bone - was removed.
  • The ligaments were over tightened.
  • The bunion was over-corrected.

 

To correct Hallux Varus, the surgeon will undo the work that was done previously. In some cases, the big toe joint may need to be fused into place. Hallux Varus is better corrected sooner rather than later, otherwise secondary problems may develop in the joint.

 

Severe Stiffness in the Big Toe Joint

After bunion correction surgery, it’s common and perfectly normal to experience some joint stiffness. You can loosen the joint up by wiggling it – this is why at UFAI, we’ve developed procedures that keep patients out of a cast.

 

However, if you’ve received bunion surgery and spent your recovery time in a cast and crutches, you might experience more stiffness than usual. Larger bunion corrections can also result in more stiffness in the big toe joint than smaller ones.

 

Stiffness is caused by the formation of scar tissue (adhesions) in the big toe joint. This can usually be corrected non-invasively:

  • We can break up the adhesions with steroid injections
  • Manipulate the joint while it’s under anesthesia.

 

If these techniques fail, we can also perform an arthroscopy to surgically remove the adhesions. This type of surgery is minimally invasive, involving only small incisions and a tiny camera. A last resort option would be to surgically stretch the joint using an external fixator to pull the scar tissue apart.

 

Arthritis

Rarely, a failed bunion surgery can result in rapid onset of late stage arthritis in the big toe joint. Arthritis occurs when the cartilage that cushions and lubricates the joint degenerates. Arthritis is characterized by pain, swelling, clicking or grinding in the joint, and the formation of bone spurs.

 

The three most common cause of arthritis from a failed bunion surgery include:

  • Improper positioning of the bone
  • Infection
  • Bone death

 

Correcting this issue may be as simple as removing the bone spurs. However, it may be necessary to surgically re-align the metatarsals or perform a fusion on the big toe joint.

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