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Bunion surgery

Also referred to as: Hallux Valgus Surgery

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A bunion  (Hallux valgus) is a swollen bony bump on the side of the big toe joint. You may experience pain and tenderness over the swollen area in certain shoes and may see callus (hard skin) over the joint where it rubs on footwear and corns between the toes. Many patients will also see changes to the foot shape with a progressive movement of the big toe over the top of the lesser toes or pushing the smaller toes towards the little toe.

It is thought that bunions are largely genetic, but wearing badly fitting shoes is thought to make the condition worse. It is thought that bunions are more likely to occur in people with unusually flexible joints and this flexibility may be inherited. .

In some cases, certain health conditions, such as rheumatoid arthritis and gout, may also be responsible for the formation of bunions. These conditions cause pain and inflammation in the joints.

Before surgery:

Your podiatrist or surgeon should have offered the following things before surgery is considered:

  • Alteration of footwear – wider/softer shoes
  • Orthoses to make the foot more comfortable if appropriate
  • Use of medication to reduce pain levels
  • Padding and offloading to reduce pain from the bunion

If these measures have not helped and your pain continues then surgery may be considered.

Surgery:

The aim of surgery is to correct the bony prominence.

Bunion surgery ideally is done under local anaesthetic (with or without sedation) but in some cases general anaestheisa may be used.

You will have a small incision to the side of the big toe joint (where the bunion is) and often the surgeons will use a combination of screws and wires to fix the bones into place.

They will use dissolvable stitches if possible and on average you will require 6 weeks off work but total recovery may be much longer.

The common types of surgery to correct bunion and associated deformities are:

Scarf / Akin osteotomy – Surgery on the bunion joint itself (1st Metatarsophalangeal Joint)

Base wedge  osteomy – Correction at the base of the 1st metatarsal bone

Weils osteotomy – realignment of a smaller toe (2nd toe most commonly)

Lapidus procedure – stabilisation of metatarso – cuneiform joint.

Your surgeon will decide on the most appropriate technique or combination of techniques for you.

Risks:

Of course with all surgery there are associated risks.

Some common risks we may see with bunion surgery are:

  • stiffness in the joint
  • pain elsewhere in the foot as the forces have been altered
  • swelling
  • elevated big toe joint
  • the bunion may return
  • Post operative infection
  • Delayed healing (long healing time)
  • Pain associated with possible scar tissue
  • Nerve damage
Bunion surgery
Bunion surgery
Bunion surgery