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Bunionectomy
When pain medication and appropriate footwear aren’t
enough to manage bunion pain, surgery might be necessary
to treat this condition. By Rear Adm. Joyce Johnson, D.O.
A
bunion, also called hallux or general anesthesia. Both medical doc-
valgus, is a deformity (valgus) tors (orthopedic surgeons, some spe-
of the joint of the big toe (hal- cializing in foot surgery) and podiatrists
lux). The usual symptom is a bump at perform bunionectomies. Your primary
the joint that might be accompanied by care provider should be able to provide a
infl ammation, pain, and swelling on the referral to appropriate clinicians for your
side of the foot. There usually is a genetic surgery. Several surgical techniques are
predisposition to the problem, but actual used to treat bunions, depending on the se-
bunion symptoms often are a result of verity of the bunion and the patient’s over-
wearing improperly fi tting shoes. Esti- all activity level. Some bunionectomies are
Review Instructions
mates are that 85 percent of women, and much more complex than others because
Before Surgery
about half of men, wear shoes that are of the extent of the joint deformity.
a73 Ask for a copy of the too small. Bunions are more common in Though the actual bunionectomy surgi-
detailed postoperative
women than men. cal procedure takes only about an hour,
instructions before un-
dergoing any surgery.
Bunions are chronic, and the deformity treatment isn’t over when the patient
When you schedule
usually gets worse over time, especially leaves the surgical center. Successful sur-
surgery, be sure you are
among those who regularly wear tight- gery requires the patient’s commitment
committed to the postop- fi tting or high-heeled shoes that increase after being discharged. Postsurgical in-
erative requirements.
pressure on the toes. Management of a structions include not putting any weight
bunion includes changing shoes and try- on the affected foot for several weeks. If
ing to reduce the pain and infl ammation. weight is placed on the foot before it heals,
Comfortable, fl at-heeled, soft leather the bones can move and proper healing
shoes that fi t loosely over the bunion often can be halted permanently. In such a case
help. Nonsteroidal anti-infl ammatory and the surgery will not be successful and
pain medication can be used when the might even need to be repeated.
pain is most severe. As you prepare for a bunionectomy, it
However, while medical management can be helpful to exercise before surgery
can help reduce pain and infl ammation, in order to strengthen your muscles in
the actual bone deformity isn’t cured anticipation of using crutches or a wheel-
with the “tincture of time.” When bunion chair, or to get a scooter of some sort
pain is no longer manageable, bunion sur- (several types are available). MO
gery (bunionectomy) can help. However,
do not consider surgery just to make the
— Rear Adm. Joyce Johnson, USPHS-Ret.,
foot look better or in hopes of wearing
D.O., M.A., is vice president, Health Sciences,
more stylish shoes.
Battelle Memorial Institute, Arlington, Va. Find
more health and wellness resources at www
Bunionectomy is an outpatient proce-
.moaa.org/wellness. For submission information,
dure that can be done under local, spinal, see page 18.
4 4 M I L I T A R Y O F F I C E R A P R I L 2 0 0 9 PHOTO: STEVE BARRETT
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dr.indd 44 22/26/09 6:34:45 PM/26/09 6:34:45 PM
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