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Goodbye Bunions, No Cutting Needed


Bunions are painful and not pretty to look at, and for about 200,000 people per year, cutting them off has been the way to treat them. Now, you may be able to say goodbye to bunions with a less invasive, no cutting needed surgical procedure.

More than half the women in the United States have a bunion, or hallux valgus, according to the American Academy of Orthopaedic Surgeons. About 90 percent of bunions are found in women, and the deformity is usually blamed on wearing shoes that are too narrow, tight, and that have high heels.

A bunion develops when the base of the big toe (metatarsophalangeal joint) becomes enlarged and protrudes from the side of the foot. The joint flexes when you walk, which causes pain. As the bunion grows larger, the pain increases and walking becomes painful. The big toe may angle toward the second toe and even move under it. Pressure from the big toe may force the second toe out of alignment, affecting the third toe as well. Walking may become very difficult, and arthritis can develop.

Until now, the traditional surgical treatment for painful bunions has been an osteotomy bunionectomy, in which the bone is cut or broken so the surgeon can realign the first metatarsal. A new surgical procedure, developed by Dr. George Holmes, head of the foot and ankle program at Rush University Medical Center, does not require cutting or breaking the bone.

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Instead, the new Mini TightRope procedure involves drilling tiny holes through the first and second metatarsal bones in the foot. Two sets of fiberwire suture, which is made of mesh and wire-like material, are placed through the holes and anchored on both sides of the metatarsals and then tightened to correct the misalignment of the big toe.

Holmes noted that the new procedure greatly reduces postoperative pain, the chances of postoperative complications, recovery time, the amount of scarring, and how long a patient needs to stay in the hospital. Patients must wear a postoperative shoe or walking boot and have their stitches removed in two to three weeks. By that time, most patients are pain-free.

Recovery time associated with traditional bunion surgery is longer, usually six to eight weeks, during which time patients cannot bear any weight on the foot. Patients must uses crutches during recovery, and persistent swelling and stiffness can occur. Complications associated with bunion surgery occur in fewer than 10 percent of patients and may include infection, stiffness of the big toe joint, infection or slow wound healing, nerve damage, and continued pain. In rare cases, deep vein thrombosis can occur, mostly among smokers.

If you want to say goodbye to bunions before they have a chance to develop, steer clear of tight, narrow shoes with high heels. Low heeled or flat shoes, such as athletic shoes, with ample room especially in the toe area are recommended. The American Academy of Orthopaedic Surgeons offers some shoe-fitting tips to help avoid bunions and other foot problems.

American Academy of Orthopaedic Surgeons
Rush University Medical Center