Bunions

Background

Bunions refer to the lumps on the inside of the big toe that rubs on shoes. The lump is in turn caused by deviation of the metatarsal bone (the medical term is ‘hallux valgus’). The condition has a strong genetic predisposition (runs in families) but shoe wear does have an effect (explaining why this condition is more common in females).

The common symptoms are of pain in the big toe, difficulty in wearing shoes and transfer pain and deformity in the smaller toes.

 

Treatment options

Avoiding wearing narrow and high heeled shoes helps. Insoles have no proven benefit. If the pain is sufficient then surgery may be recommended.

 

Benefits of surgery

Surgery can be performed on both feet at the same time or one at a time. Unless there are medical problems, the procedure is performed under general anaesthesia as a day case. The bones are cut and fixed with headless screws (and sometimes staples). Some patients are suitable from ‘minimally invasive surgery’ which is the same procedure performed through small incisions that do not require stitches.

 

Risks of surgery

Risks are minimal in non-smokers.

 

Recovery

A bandage is applied (no plaster of Paris) and immediate weight bearing is allowed in a surgical shoe. The wounds take 2 weeks to heal and the bones 3-4 months. The swelling can take up to 6 months to fully subside. This more modern type of bunion surgery is a very successful (compared to the older operations) and patients are generally very happy with the outcome.

Driving is not advised for 6 weeks if the right foot is operated on (your brake foot).

 

Before surgery                                                              After surgery