“I keep getting bunions--what should I do to prevent them?”

Recurrence of bunions after surgery can be due to under correction, genetics, use of improper shoe gear, or ligament laxity.

Dr. Lui

It sounds to me that you had a lesser procedure done than necessay.
Bunions should rarely recur and if so, only after many years, if the proper procedure done. I am hoping you did not have an in-office, minimal incision surgery done. This is often inadequate. Go see an experienced, hospital trained podiatrist who hopefully can rectify your situation. Good luck.

Hello. I am sorry to hear of your reoccurring bunions. Unfortunately it sounds like you need revisional bunion surgery if it has recurred so soon. Your only other option is custom orthotics. I recommend you seek a second opinion. God bless.

Bunion deformities can be challenging to address both non operatively and operatively. Over the past century of modern medicine, there has been well over 100 surgical procedures identified for the correction of this deformity. The number of procedures suggests we may not have identified one single procedure that produces a sustainable outcome in every instance. Every deformity is unique to the individual, and its management must be specific to the circumstance particularly regarding its etiology and manifestation. In other words, it is not a one size fits all approach regarding procedures performed. Over the past 5 to 10 years we have gained a greater appreciation for the multiplanar nature of the deformity. Many
procedures directly served as a translational correction, which means, cutting and shifting the bone over. Unfortunately, this fails to address the rotational deformity that is appreciated. There has been a greater emphasis in recent years to address both the translation but also the rotation of the bone. We have embraced again treating the deformity at the base of the metatarsal where it forms a joint with the midfoot cuneiform bone. By fusion this joint we can derotate and move the bone over and maintain it in this corrected position. It is essentially placing a crooked building straight again on its foundation. The advent of newer orthopedic plates and screws have allowed this procedure to gain significant traction as the need for prolonged immobilization and limited weight bearing has been mitigated. Ultimately, the success of the surgery not only depends on the selection of a correct procedure for the particular circumstance, but the native tissue of the individual. Meaning the preservation of correction requires the individual to have healthy tissue to support prolonged repair. If this is not the case, then success may be limited, and other options should be considered to include nonsurgical treatment or joint fusion of the great toe.

Depends on the surgery you had. Was it to remove the bump or correct the abnormal angle of the bone? It should not recur after 1 year.

Ahmad Farah, DPM

It is not common to get recurrent bunions if the original surgery has been done properly, preferably by a board certified foot and ankle podiatric surgeon. I would recommend that you seek one out and get a second opinion. In doing bunion surgery for more than 30 years, as hard as it is to believe, I have never had a recurrent bunion requiring a second surgery. Now it is possible that some patients have gone to another foot/ ankle surgeon, but I think I would have found out about it(requiring medical records, x rays, etc.). That has never happened.
If the correct procedure is done, it is unlikely you will develop a recurrent bunion. Also following bunion surgery, properly fabricated custom foot orthotics are very effective in decreasing the forces that contribute to bunion formation.

Wow, that is really unfortunate. It would be hard for me to comment since I don't have your X-rays and you in front of me. One thing you can do is go on Amazon and purchase a bunion splint to be worn at night. Also, do not wear any style of pumps or heels.

The most important preventative method is shoegear and supports. Recurrences can happen after surgery, but are far less common if you wear the proper shoes and be fitted for a custom orthotics that controls the biomechanics of the feet.

If you bunion keeps coming back it may be a function of poor-fitting shoes and lack of proper foot function. If your shoes do not give your feet proper support, especially arch support, then your foot is not function at its best when you are walking, standing, or running. This results in joint being mal-aligned causing other joint to move improperly.
If your shoes are constricting feet or toes or pushing toes in one way (in the case of narrow tipped shoes) then you are providing the perfect environment for bunions to never be corrected

Bunions occur due to a muscle imbalance in the foot. Despite having them corrected surgically, if the mechanics that are contributing to the muscle imbalance are not addressed, recurrence if a possibility. I recommend you discuss the options to address the muscle imbalance with a foot and ankle surgeon (podiatrist)

Bunions are caused by a combination of tight or pointed toed shoe gear, the biomechanics of your foot and ankle, and genetics, to some degree. But if you needed 2 bunion surgeries on the same foot in the same year, your surgeon either did a poor job, did not fully grasp the biomechanics of your particular foot and did not do the correct procedure, or you may have done something during the post-operative course to allow recurrence of the bunion. I say this with the greatest of sensitivity, but a 3-year trained Podiatrist that is board certified in surgery is the best possible type of doctor that you can have evaluate and surgically treat the problems of your foot and ankle. Orthopedic surgeons who specialize in foot and ankle surgery only require a 6 month to 1 year fellowship to do the same thing a 3-year residency trained Podiatrist learn over the course of 7 years. So the proper choice of surgeons is invaluable.

Bunions are genetic, and even after surgery, the structure of your foot wants to continue forming them. The best way to minimize recurrence is to wear custom orthotics and proper fitting shoes.

Depends on the surgery that was done. The wrong procedure may have been chosen for you and that is the reason why they returned.