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

BunionsBunions 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.

Symptoms

  • Pain and Discomfort – Commonly the pain is in the great toe joint and may be cramping in the toes and feet.
  • Redness and Inflammation – Redness and inflammation are common the great toe joint.
  • Deformed Shape – The front of the foot is usually wider because of the big toe deviating towards the 2nd digit and the inside bony bump.
  • Numbness – Numbness, tingling, and burning may be found in the great toe.
  • Decrease Motion – Great toe joint stiffness may occur causing balance issues.
  • Corns and Calluses A corn may develop between the 1st and 2nd toe from bony pressure. A callus may form on the side or bottom of the great toe joint causing pain with pressure.

Treatment

Conservative Treatment:

  • Padding – Pad the bunion area to reduce pressure pain.
  • Functional OrthoticsOften 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.

 

Real People, Real Results

Many of our patients have found relief from foot pain through treatment at South Hill Foot & Ankle Clinic! Hear from one of our happy success stories:

Two years ago I clipped your announcement of South Hill Foot Care from the Spokesman Review, and held onto it until having courage enough to set an appointment for a consultation with your office. Hearing the horror stories about bunion surgery which others had experienced locally was most frightening, until my pain forced me to take action. My hammertoe and bunion continuously hurt like a bad toothache. I called your office and spoke with Dawn who took time explaining the minimal invasive surgery you provided. Because of my age, having the surgery with topical anesthetic was most appealing. I decided to set the appointment with your office.

Upon arriving at your office, nearly a two hour drive away, I showed up five minutes late. There was unexpected road construction which delayed my arrival. I was so afraid that the appointment would need to be rescheduled. Much to my surprise your staff was most understanding and stated that Dr. Markewych would still be able to provide the consultation service.

Dr. Markewych, you performed my hammertoe and bunion surgery on January 4, 2018 and I am so happy to report the surgery restored optimum podiatric health on my left foot. It is now four months after the surgery and I am walking with ease and without pain, truly a blessing. Dr. Markewych, after you delivered the very best possible service, I am sorry not to have visited you much sooner. I am a outdoor person who enjoys gardening and now can do so without the painful foot pain. I plan to set another appointment for you to correct the bunion on my right foot in January 2019.

I would like to thank you and your entire staff for such skillful, pleasant and courteous treatment. I truly felt like family. Your staff at The Walk Shoppe assisted me in finding comfortable shoes to wear after surgery. Stephanie was most helpful and patient while we found not only one pair but two. Surely they are the most comfortable shoes I have ever worn. I cannot praise you and your staff enough for the professional service you provided in such a warm and caring atmosphere.

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