Hammer toe removal due to bunion. Is this the best way to handle such a bunion?

Hi!

Bunion surgery, which is typically reserved for cases where the bunion causes significant pain or severe deformity, involves various surgical procedures. The decision to remove a toe, such as the second toe, due to a bunion is less common but can be considered in certain situations. For instance, if the bunion has caused severe deformity and the toe is now overlapping or causing significant pain or disability, or if there is vascular compromise or severe arthritis in the toe, the surgeon might recommend removal for relief and to prevent further complications.

The treatment options for bunions generally include:

1. Conservative management: This involves using wider footwear, custom orthotics, toe spacers, and other non-invasive methods to reduce pain and pressure on the bunion. This doesn’t correct the deformity but can alleviate symptoms.

2. Corrective surgery: There are many types of bunion surgeries that aim to correct the deformity by realigning the joint, tendons, ligaments, and bones. This can include:

   • Osteotomy – Cutting and realigning the joint.
   • Arthrodesis – Fusing the joint.
   • Exostectomy – Removing the bump of the bunion without aligning the joint (rarely done alone for severe bunions).

3. Toe amputation: This would be a more radical approach and is usually reserved for the most severe cases where the toe is not salvageable or other health conditions complicate the picture.

If surgery is on the table, the specific type of surgery recommended would be based on several factors, including:

• The extent of the deformity.
• The patient’s overall health.
• The presence of any other conditions, such as diabetes or peripheral arterial disease.
• The patient’s level of pain and disability.
• The surgeon’s assessment of what procedure will offer the best outcome with the least risk.

It’s understandable that the idea of amputation sounds quite drastic, especially if other options haven’t been fully explored or discussed. In the context of bunion surgery, toe amputations are not the standard first approach if the toe is otherwise healthy and if less invasive options might provide relief.

It’s very important for your mom to get a second opinion if you’re uncertain about the recommended surgical plan. A second opinion can provide more insight into the potential benefits and risks of the surgery, as well as alternative treatments. Consulting with a foot and ankle orthopedic surgeon or a podiatric surgeon who specializes in bunion correction might provide more clarity on the best course of action for your mom’s specific situation.

Remember, the decision to undergo surgery, especially at an advanced age, should be made carefully, weighing all potential risks and benefits, and should take into consideration the patient's overall health status, lifestyle, and goals for treatment.