When a patient elects to surgically correct a bunion deformity, both the physician and patient invest so much time and energy. In addition to performing the bunion correction, the physician analyzes angular deformity and chooses from different surgical-procedure options to fit the patient and the patient’s expectations. Moreover, the patient makes a commitment to rest the operated-on extremity and wear protective devices religiously for several weeks. Sometimes, this even requires the patient taking time off from work.
Because one of the main complications of corrective bunion surgery is recurrence, it is necessary to take steps to prevent this unwanted and avoidable complication.
To review, a bunion deformity is when the big toe presses on the second toe and adjacent digits. A mal-aligned big-toe joint can even produce a prominent bone bump at the top or at the side of the joint. A patient may notice stiffness and painful or decreased motion at the joint. In some patients, the deformity can be treated with oral or topical medications, shoe-gear modifications, padding and shoe inserts (custom or over-the-counter). Surgical correction of a bunion deformity usually is warranted when non-surgical options fail to provide relief or if the deformity is more advanced or severe.
There are many ways to help prevent recurrence of a surgically corrected bunion. Just like a dentist usually fits a patient with a mouth retainer after braces, that same concept applies to a nighttime bunion splint. When healed after surgery, a patient can wear a soft, comfortable splint to prevent shifting of the newly realigned toe. It usually is worn when the patient is non-ambulatory or during sleeping hours. It also is necessary to focus on what caused the bunion in the first place.
Bunions usually are caused by an abnormal foot structure or abnormal walking/gait pattern that creates instability at the big-toe joint. If the abnormal foot structure or gait pattern can be corrected with custom orthotic shoe inserts, it definitely is worthwhile to be fitted for these. A custom orthotic is made from a mold or impression that captures the foot abnormality. The insert device is then made from that mold, effectively producing a comfortable insert that is placed in the shoes. This insert is designed to correctly align the joints of the foot, which provides stability to the big-toe joint and the rest of the joints of the forefoot.
Finally, wearing good, supportive shoes will reduce the risk of recurrence. For example, you should pick a shoe with a firm back and one that provides good arch contact.
I know that all the ladies are thinking, “What does this mean for high heels or cute dress shoes?”
Apply the “guilty pleasure” rule to heels. Wearing them in moderation means once or twice per week for about two or three hours at a time. Never wear heels when walking long distances or for more than four or five blocks.
So ladies, enjoy those fabulous pumps or awesome strappy sandals while employing the same rules that apply to delicious things such as chocolate cake!

Runkel was born and raised in Wisconsin, where she earned her undergraduate degree at Marquette University in Milwaukee. She completed podiatry school at the William M. Scholl College of Podiatric Medicine in North Chicago, where she graduated with honors. Runkel completed residency training in Chicago and was chief resident throughout her second year of residency. She works at Atlantic Foot & Ankle Specialists.