Bunions

Dr. Borys Markewych performs a minimally invasive ambulatory surgical technique to correct bunions. It involved making percutaneous incisions (approximately 1/8 inch) to remove the bony bump located on the inside of the foot behind the big toe. Another small incision is made on the top of the big toe to align it in proper position. With these small incisions, it minimizes scarring with great cosmetic results.

A bunion is a bone deformity with the 1st toe deviated toward the 2nd digit and a painful bony bump on the inside of the foot. The bony bump is located in the joint behind the big toe that may become swollen, red, stiff and painful. You can also develop a bunion on the outside of the foot called a Tailor’s bunion or bunionette located near the little toe.

Anatomy

Bunions are the lateral deviation of the big toe toward the 2nd toe and the development of a bony bump on the inside of the foot. In addition to causing pain, the bunion changes the shape of your feet making it hard to find shoes to wear and even making walking difficult, The Walk Shoppe is located next to the clinic and offers shoes with comfort and style.

Causes 

90% of bunions are hereditary in nature causing abnormal foot structure and mechanics. People with flatfeet or pronated feet appear to be more prone to the development of bunions. Footwear such a high heels, pointed shoes or ill-fitting shoes can contribute to the development of bunions. Injuries can also be a factor in developing bunions.

Treatment

Conservative Treatment:

• Padding – Pad the bunion area to reduce pressure pain.
• Functional Orthotics – Often prescribed by your doctor to help control misalignment, relieve pressure on the joint and decrease symptoms. Possibly this will prevent worsening of the deformity.
• Footwear: The doctor may suggest proper fitting supportive shoes or modifications for your foot type and activities.
• Medication: Take over the counter anti-inflammatory such as ibuprofen or acetaminophen to reduce inflammation and manage pain.

When conservative treatment fails or the bunion progresses to the point where conservative treatment is no longer a viable option, surgical intervention may be needed to correct the deformity.

Surgical Treatment

Minimally Invasive Bunionectomy:

Dr. Markewych does a minimally invasive ambulatory surgical technique to correct bunions. The small surgical incisions enable the surgeon to use fine specially designed instruments to obtain the best cosmetic result. Sometimes additional procedures may be required such as correcting a second hammertoe or low metatarsal bones often seen in conjunction with bunions. These procedures are also done with the minimally invasive incision surgery and the doctor would be able to determine if this is needed during your foot exam, which would involve x-rays unless you have had some recently taken.

Surgery is performed under Fluoroscopic viewing. There is generally less trauma to the tissue and surgical times are lessened with this technique, reducing pain and recovery time. Less suturing is necessary and often times no sutures are used. Postoperative patients ambulate immediately and are often placed in a surgical shoe or boot to aid ambulation.

MIS surgeons are able to rely on an external compression dressing with taping/splinting for stabilization immediately after surgery, eliminating the need for pins or screws enabling immediate ambulation. Most of the time it is unnecessary to fuse the toe joints.Getting back into regular type shoes depends on

Getting back into regular type shoes depends on rate of healing and amount of swelling, which is very individual. You will have a bulky dressing the first week. Dr. Markewych usually likes to see you back at the clinic after two to three days for redress, or 5 days after surgery for our out-of-town patients. In one week your dressing is changed to band-aids or bandage strips, a spongy material toe separator and disposable ace bandage type wrap which you yourself change daily. This dressing is worn three to four weeks. No dressing is usually required after this.

Dr. Borys Markewych performs a minimally invasive ambulatory surgical technique to correct bunions. It involved making percutaneous incisions (approximately 1/8 inch) to remove the bony bump located on the inside of the foot behind the big toe. Another small incision is made on the top of the big toe to align it in proper position. With these small incisions, it minimizes scarring with great cosmetic results.

A bunion is a bone deformity with the 1st toe deviated toward the 2nd digit and a painful bony bump on the inside of the foot. The bony bump is located in the joint behind the big toe that may become swollen, red, stiff and painful. You can also develop a bunion on the outside of the foot called a Tailor’s bunion or bunionette located near the little toe.