Bunions are a common, sometimes painful foot deformity that can cause difficulty with footwear and create an unstable foundation for standing and walking. The medical term for a Bunion is Hallux Valgus. Many people believe that their Bunion is a growth or a bump on the side of the foot. What looks like a bump is actually the end of the metatarsal bone which becomes more noticeable with time as the big toe subluxes or dislocates towards the lesser toes. Hallux Valgus results from some combination of nature and nurture. In other words, a person is born with the type of foot which is prone to a bunion or Hallux Valgus and the deformity progresses with time. There are many different surgical procedures which have been performed to remedy the deformity caused by the Hallux Valgus. Most of these procedures create a secondary deformity rather than addressing the Hallux Valgus or Bunion at its root cause. The Hallux Valgus deformity is caused by an unstable first metatarsal bone which deviates away from the rest of the foot. This condition is accelerated and made worse by a contracture of the calf muscle. This combination of Hallux Valgus and a tight calf muscle were identified and described perfectly in 1935 by DJ Morton. The best surgical procedure for correction of bunion is the Lapidus Procedure because it addresses the problem at it’s source by realigning the entire metatarsal and stabilizing it to the middle of the arch. The Lapidus procedure has been Dr. Rocco’s preferred method of Hallux Valgus correction since 2002.
While the Lapidus procedure is an extensive foot reconstruction and substantially more surgery than simply removing a bump, the results are definitive and have demonstrated permanent correction. Other procedures designed to correct Hallux Valgus may not be sufficient to fully correct the problem, and the Hallux Valgus may recur.
Traditional Bunion surgery has a reputation for being a very painful procedure. Recent advances in surgical technique now allow the Lapidus procedure to be performed in a less invasive manner with smaller incisions. Because of Minimally Invasive Surgery (MIS), patient recovery is faster and less painful with earlier return to function. The Lapidus Procedure is performed in an ambulatory setting with general anethesia and a nerve block, which allows the patient to wake up with little to no pain. The block lasts approximately 16-48 hours, and when the block wears off, pain medication is used. Patients are placed into a splint at surgery and are non-weightbearing with the assistance of a walker or knee scooter during the first 2 weeks following surgery. After 2 weeks patients are transitioned to a boot and are able to touch down on the heel. The boot can be removed for bathing on a daily basis. At 4-6 weeks after surgery, depending on the circumstances, the patient may gradually advance to weightbearing as tolerated and begin Physical Therapy. Physical therapy is important to help improve motion and re-establish a normal gait and function.
