Treatment Options
What Are My
Treatment
Options?
There are several treatment options for bunions – both surgical and nonsurgical depending on the severity of the deformity.
Non-surgical or Conservative Treatments
Many nonsurgical treatments for bunions may be effective in reducing pain.
Your doctor may recommend a variety of options to try to reduce bunion pain relief.
Widened footwear or shoe inserts and avoiding heels
Wear comfortable shoes, especially if poorly fitting shoes exacerbate your bunion pain. Installing bunion pads in your footwear may help to reduce the rubbing of your bunion against the shoe.
Over the counter medications
Your doctor may recommend some over-the-counter medications to provide relief from bunion pain such as; acetaminophen, ibuprofen, or naproxen.
Padding & bracing to relieve pain & pressure
Your doctor may suggest the use of padding or bracing to support your foot and limit pain. These options may be customized, administered in a clinic, or purchased over-the-counter.
Ice & massage
Ice and massage may help to relieve pain after prolonged standing or walking.
Traditional Surgical Options
Traditional surgical options rely on a mixture of bony cuts to reposition the anatomy and relieve the contracture to pull the toe in alignment. Fusion of the big toe may be needed to address contracture and/or arthritic changes in the joint.
More severe bunion correction may include fusing of the 1st Tarsometatarsal (TMT) joint in order to achieve and maintain correction. Fusion involves removing cartilage (flexible connective tissue found in-between joints) and placing the bones together to heal.
Scars from bunion surgery will depend on the exact surgical approach determined by your surgeon. In the traditional bunion surgery methods, larger scars may left behind because they may require a four to six-inch incision, extended recovery times, and leave the patient with visible scar.
As you explore surgical options, be sure to consult your doctor for best practices in treatment. Understand what the benefits and risks of surgical intervention can be, as well as any possible complications.
What are my Options?
As a patient you need to know that depending on the type and severity of your bunion there are many ways to treat it.
It is important to make sure that you consider options instead of looking for a one-sized-fits-all approach.
See below for minimally invasive treatment options offered by Paragon 28.
Phantom® MIS
The new Phantom® MIS procedure consists of three small surgical incisions made in the foot, and the intramedullary nail placed at the point of the bunion. Recovery time may be quicker than traditional surgery because of its minimally invasive nature.
Precision® MIS
The Precision® MIS Bunion System, known as a Distal Metatarsal Osteotomy (DMO), may be considered for mild to moderate bunion deformity. This procedure IS JOINT SPARING, and may allow you to get back to your normal activities faster because of its minimally invasive surgical approach.
PHANTOM® MIS NAIL
Smaller incision
= Less Scarring
The Phantom® MIS procedure is designed to correct your bunion with three separate incisions, which are each 0.4 inches or less. This procedure requires shorter incisions than traditional approaches leaving you with far less scarring.
Smaller Less Visible Scars
Our Minimally Invasive System reduces the length of the incision, resulting in smaller scars when compared with traditional approaches.
Minimally Invasive
Limited dissection of surrounding tissues may allow for a more rapid recovery post operatively⁶.
No Hardware Prominence
The Phantom® Nail; when inserted, is completely in bone which minimizes concerns related to other procedures where the hardware rests on the bone, potentially causing irritation with shoe wear post-surgery⁷.
See if the MIS procedure is right for you
Take the survey below to see if you qualify for a new minimally invasive bunion surgery.
Your Concerns Related to Surgery are Shared by Most:
- How long will I be in pain?
- How long before I return to normal activity?
- Will I have a big scar?
- Will my toe look normal again?
Bunions start out small but can progressively worsen over time. Fortunately, treatment for bunions has evolved and your bunion can be addressed through multiple nonsurgical and surgical options depending on its severity. Emergent less invasive surgical options may allow for a more rapid return to your favorite activities!
Frequently Asked Question
Are my shoes causing my bunion?
Poor fitting shoes may contribute to the deformity as it can push the toe into an unnatural position. Over time, the soft tissue in your foot may become accustomed to the new positioning and cause a worsening deformity.
When do I need to have surgery – how long should I delay?
Bunion deformities are progressive conditions which may not improve without intervention. Addressing these deformities early before arthritic changes begin to take place in the toe may allow for interventions which do not require fusions or other more invasive procedures.
How long until I can get back to normal activities?
This is dependent on your surgeon’s recommendation and procedure utilized. Please see product pages for their timelines.
Is the Phantom® MIS procedure covered by insurance?
Coverage is dependent upon the provider. The Phantom® MIS procedure is a bunion correction procedure, which is a common occurrence for insurers.
If I had a previous operation that failed, can my toe still be corrected?
Surgeons are using the Phantom® MIS procedure to address previously failed operations as well as primary surgical intervention.
What pre-existing health conditions would keep me from having the Phantom® MIS procedure?
The Paragon 28® Phantom® Intramedullary Nail System implants are not designed or sold for any use except as indicated. Use of the Phantom® Intramedullary Nail System is contraindicated in the following situations:
- Active, suspected or latent infection in the affected area
- Patients who are physiologically or psychologically inadequate
- Patients previously sensitized to titanium
- Longitudinal splits or longitudinal fractures
- Insufficient quantity or quality of bone to permit stabilization, conditions that retard healing (not including pathological fractures) and conditions causing poor blood supply
- Open epiphyseal plates
- In patients where there is a possibility for conservative treatment
- Indications not included in the INDICATIONS FOR USE
Can the Phantom® MIS procedure be performed as an outpatient procedure and how long should I expect surgery to last?
The procedure is usually performed with a local anesthetic block and sedation. The procedure may take anywhere from 45 minutes to two hours and may be completed in an outpatient setting so you can return home the same day.
Do all doctors perform the Phantom® MIS procedure?
Surgeons are being trained every week on this novel procedure. To find a surgeon near you, please utilize our surgeon finder tool.
Are there physical limitations I should be aware of following the surgery?
Depending on your surgeon’s post-operative care plan, you may be placed in a cast for the first few days to properly heal, which will limit any weight-bearing. Your surgeon will then move you into a partial weight-bearing boot for the duration of your healing process, which could lead up to 4-6 weeks post-surgery before you can start to place weight on your foot in comfortable shoes.
How frequently will I need to return to my doctor following the surgery?
Sutures are typically removed two weeks following the surgery and if the surgeon pins the toe, the pin can be removed at two to four weeks following the surgery.
Will I have any scarring following the procedure?
With the Phantom® MIS procedure, you will notice significantly less scarring as compared to traditional approaches. These scars can be easily treated to lessen any long-term cosmetic outcomes with the Phantom® MIS procedure.
When can I return to all normal activities following surgery?
All restrictions related to shoes are at the discretion of your surgeon. Patients may return to normal footwear in as few as 4-6 weeks.
Important Risk Info
Only a surgeon can tell if the Phantom® Intramedullary Nail, Phantom® MIS Procedure and/or Precision® MIS Bunion System is right for you. There are potential risks, and recovery takes time. Potential risks include but are not limited to infection, discomfort, or swelling due to balancing and introduction of the implant, loosening of the implant, and loss of correction. Refer to full list of warnings precautions, and contraindications within the Phantom® Small Bone Intramedullary Nail and Precision® MIS Bunion System Instructions for Use at https://paragon28.com/ifus/
Surgeon Finder Disclaimer
The surgeon information listed in the Surgeon Finder is provided for informational purposes only and does not represent an endorsement or warranty of any particular surgeon. The database does not include an exhaustive list of all surgeons within a particular geographic area or all surgeons who use/have used a Paragon 28® product. Only those who have expressly subscribed to be listed on the site and are confirmed to be either Paragon 28® trained and/or experienced are included. These are the only criteria for inclusion. Paragon 28® does not pay a fee or any other type of remuneration for participation. Choice of surgeon should be solely based upon a patient’s own investigation of a particular surgeon’s training, education, experience and reputation.
For the contraindications, potential complications and adverse reactions, warnings and precautions associated with this device, please refer to the device specific instructions for use here.
Sources
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Gribbin CK, Ellis SJ, Nguyen J, Williamson E, Cody EA. Relationship of Radiographic and Clinical Parameters With Hallux Valgus and Second Ray Pathology. Foot Ankle Int. 2017;38(1):14-19. doi:10.1177/1071100716666562
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Lai, M. C., Rikhraj, I. S., Woo, Y. L., Yeo, W., Ng, Y. C. S., & Koo, K. (2018). Clinical and Radiological Outcomes Comparing Percutaneous Chevron-Akin Osteotomies vs Open Scarf-Akin Osteotomies for Hallux Valgus. Foot & Ankle International, 39(3), 311–317. https://journals.sagepub.com/doi/10.1177/1071100717745282
Peterson KS, McAlister JE, Hyer CF, Thompson J. Symptomatic Hardware Removal After First Tarsometatarsal Arthrodesis. J Foot Ankle Surg. 2016;55(1):55-59.doi:10.1053/j.jfas.2015.06.001
Prieto-Diaz, C., Anderle, M. R., Brinker, L. Z., Allard, R., & Leasure, J. (2019). Biomechanical Comparison of First Tarsometatarsal Arthrodesis Constructs Over Prolonged Cyclic Testing. Foot & Ankle Orthopaedics. https://journals.sagepub.com/doi/10.1177/2473011419892240