Bunion surgery

A bunion (also referred to as a hallus valgus) is an enlargement of bone or tissue around the joint at the base of the big toe. The term 'bunion' is used to describe a bump on the side of the big toe caused by changes in the bone framework at the front of the foot. These changes can cause the big toe to turn in toward the second toe which throws the bones out of alignment.

The bump therefore indicates additional bone formation, often in combination with a misalignment of the big toe. This can make it harder for people to find shoes to fit in addition to causing a considerable amount of pain and discomfort.

A less common bunion called a Tailor's bunion, or Bunionette is a condition caused as a result of inflammation and changes occurring in the foot's bony framework. This results in the enlargement of the fifth metatarsal bone at the base of the little toe. The bone starts to protrude outward, while the little toe moves inward. This shift creates a bump on the outside of the foot that becomes irritated whenever a shoe presses against it.

Both types of bunion are similar in symptoms and causes.

Symptoms

The symptoms of bunions include

• Pain over the joint, aggravated by pressure from shoes
• Pain or soreness
• Inflammation and redness
• Red, calloused skin along the inside edge of the big toe
• A burning sensation
• Possible numbness
• Big toe turned toward the other toes
• Irritated skin around the bunion
• Pain when walking

Symptoms usually appear at later stages although some people never have symptoms.

Bunions are a progressive disorder meaning that they get worse over time; after a while, the foot can hurt in different places even when shoes are not being worn because it can become a mechanical function problem of the forefoot. The leaning of the big toe gradually changes the angle of the bones over the years and slowly creates the tell-tale bump, which becomes increasingly visible.

Diagnosis

A doctor can usually diagnose a bunion simply by looking at it. A foot x-ray can also highlight the characteristic abnormal angle between the big toe and the foot.

Causes

Bunions most commonly affect women and it has been suggested that tight-fitting, high-heeled or narrow-toed shoes might increase the risk for bunion formation.

However, unsuitable footwear is not usually the sole cause of bunion. Although wearing shoes that crowd the toes can sometimes make the deformity get progressively worse, in many cases, bunions are caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.

Other risks affecting the development of bunions include nerve conditions that affect the foot, rheumatoid arthritis, and injury to the foot. Bunions are common in ballet dancers.

Procedure

A current method of forefoot surgery and in particular Bunion correction is performed through an open incision. This takes time to heal and can have complications e.g. infection, prolonged pain and swelling.

However, it is now possible for suitable patients to have minimally invasive bunion correction operations involving two or three small "percutaneous" or "key hole" incisions as a day case procedure using a special mini x-ray machine. This allows rapid healing and reduced pain and stiffness of the joint with minimal complications. If required, this surgery can be performed under a local anaesthetic and sedation. Immediate weight bearing is possible and you are able to walk out of the Clinic straight after your surgery. Healing time is between 4 to six weeks although swelling may last a little longer.

Another minimally invasive technique performed by surgeons from Europe has been described as a "five minute procedure." Instead of using a wire which remains in the foot after surgery and requires removal later, a stable fixation can be achieved with specially designed internal screws that remain inside the bone. This technique is more advanced as a two level, more stable and controllable realignment is achieved.

For more information about costs and the different surgeries available, please ask our surgeons a question via the portal on the homepage. Within 60 minutes you will get a free answer containing all of the information you need and there is no obligation.

FAQ

WHAT IS THE TOTAL LENGTH OF TIME ON AVERAGE FOR COMPLETE RECOVERY AFTER MY OPERATION?

After your procedure it can take up to 4 to 6 weeks for complete recovery.

WHEN CAN I START DRIVING AGAIN AFTER MY OPERATION?

You can start driving again from 4 weeks following the operation.

WHEN CAN I RETURN TO WORK AFTER MY OPERATION?

For sedentary jobs you may return to work a week after your operation, but for physical jobs and jobs were you have to stand up a lot it may be 4 to 6 weeks before you can return to your job.

AFTER MY OPERATION WHEN CAN I START EXERCISING AGAIN/TAKE PART IN SPORTS?

You may start exercising/taking part in sports 6 to 8 weeks after your operation.

WILL MY FOOT/FEET BE IN A BANDAGE AFTER MY OPERATION AND IF SO HOW LONG FOR?

Yes you will need to keep a bandage on the foot/feet for 2 weeks after your operation.

DO I NEED TO WEAR ANY DIFFERENT FOOTWEAR FOLLOWING MY PROCEDURE AND IF SO HOW LONG FOR?

Yes you will need to wear special surgical shoes for 4 weeks after your operation.