Operations to Remove a Bunion

If the feet hurt, everything else seems to hurt as well. Foot problems and conditions can cause trouble with standing, walking and running, and can be a source of difficulty in performing daily tasks. A study by the American Orthopedic Foot and Ankle Society found that 88 percent of American women wear shoes that are too small, and 55 percent of those have bunions. There are several surgeries that can treat these problems.

Keller Procedure

The Keller bunionectomy procedure typically involves the surgical removal of the cartilage surface and a portion of the base of the bone in the big toe, called the proximal phalanx, which comes in contact with the first large bone in the foot, called the first metatarsal. The joint that is formed by these two bones is called the first metatarsal-phalangeal joint.

A study conducted by Drs. Marc and Edward Rankin of Washington D.C. concluded that this procedure can be a successful treatment option for chronic arthritis pain of the great toe joint if performed on the right patient for the right reasons.

The Keller procedure is a simple way to relieve pain in cases of severe arthritis, or in patients whose condition or other factors such as age or mobility status prohibit more complex foot surgery.

Silver Bunionectomy

The Silver Bunionectomy procedure typically involves the removal of the bony prominence, or spur, that exists along the medial, or inner, portion of the joint of the big toe which forms as a result of chronic pressure in this area from factors such as ill-fitting shoes.

The constant rubbing causes the foot to react and produce excess bone, called an exostosis, at the site of the pressure. The Silver procedure involves the removal of this exostosis, or bony prominence, which in turn eliminates the pressure point on the foot when wearing shoes.

A study by Scranton, et al., published in 1995 established that the Silver procedure is a simple and successful way to treat bunion formation in patients who did not display any associated angular deformity of the foot.

McBride Procedure

The McBride bunionectomy procedure is an extension of the simpler Silver procedure, and while it includes and duplicates the Silver bunionectomy, additional steps are performed, including transferring a small tendon from the base of the big toe to the first metatarsal bone in the foot, with the intent of solving the angular deformity of the foot that causes widening and contributes to angulation of the big toe, thus improving the general alignment of the foot and big toe.

In 1991, Mann and Pfeffinger reviewed a large population that underwent McBride procedures and found a 92 percent patient satisfaction rate, with 10 percent being able to wear any type of shoe after the procedure. They concluded that the McBride procedure should be considered in a limited population demonstrating mild-to-moderate foot deformities.

Austin Procedure

The Austin bunionectomy procedures involves the removal of the exostosis, or bony prominence along the inner border of the big toe joint, along with the creation of a cut in the bone, called an osteotomy, just beneath the metatarsal head, or the round joint head of the bone, in a V-shape called a chevron. This osteotomy enables the head of the metatarsal bone to be slid laterally, or towards the little toe.

The combination of removing the bone spur and cutting and sliding the head of the first metatarsal bone results in the elimination of the spur as well as the reduction of the angular deformity of that bone and the big toe, effectively narrowing the foot. Reducing the angle and narrowing the foot eliminates the pressure point in the area where the bunion formed in the first place.

About this Author

Ken Chisholm is a freelance writer who began writing in 2007 for LIVESTRONG.COM. He has experience in health care, surgery, nursing and orthopedics as an orthopedic physician assistant and a registered nurse. He holds a bachelor\’s degree in business from the University of Findlay, Ohio.