Bunion Surgery

Bunion Surgery
A bunion, also known as hallux valgus, is bony prominence at the base of the big toe, which often results in pain, redness and rubbing against footwear. The 1st metatarsal bone abnormally angles outward towards the other foot from its midfoot joint. A bunion can change the shape of your foot, make it difficult for you to find shoes that fit correctly and worsen the symptoms if left untreated.

Causes

Although it is not clearly understood why bunions occur, possible causes include:

  • Family history and genetics
  • Arthritis (inflammation of the joints) including rheumatoid arthritis, psoriatic arthritis and gout
  • Neuromuscular conditions such as cerebral palsy (affects movement and co-ordination)
  • Connective tissue disorders such as Marfan’s syndrome (affects the connective tissues)
  • Tight fitting shoes that are too tight, narrow or high heeled.

Signs and symptoms

The main indication of a bunion is the pointing of the big toe towards the other toes of the foot. Other signs and symptoms include:

  • Pain and swelling over the big toe that increases while wearing shoes
  • Swelling with red, sore and calloused skin at the base of the big toe
  • Inward turning of the big toe pushes the second toe out of place
  • Bony bump at the base of the big toe
  • Sore skin over the bony bump
  • Difficulty walking and wearing shoes

Diagnosis

The diagnosis of a bunion includes taking a medical history, and performing a physical examination to assess the extent of misalignment and damage to the soft tissues. Your doctor will usually order weight bearing X-rays (i.e. taken while standing) to access the severity of the bunion and deformity of the toe joints.

Treatment

Your doctor will initially recommend conservative treatment measures with the goal of reducing or eliminating your foot pain.

Such measures can include:

  • Medications for relieving pain and inflammation
  • Wearing surgical shoes with a wide and high toe box, and avoiding tight, pointed or high-heeled shoes.
  • Use of orthotics to realign the bones of your foot and ease pain.
  • Padding the bunion
  • Ice applications several times a day

Conservative treatment measures can help relieve the discomfort of a bunion, however these measures will not prevent the bunion from becoming worse.

Surgery

Surgery is the only means of correcting a bunion. Surgery is also recommended when conservative measures fail to treat the symptoms of bunion. The best person to perform this surgery is an orthopaedic Surgeon with a special interest in disorders of the foot and ankle.

There are many surgical options to treat a bunion. The common goal is to realign the bones in the foot, correct the deformity, and relieve pain and discomfort. The surgery is performed as an outpatient procedure, under the effect of a light general anesthetic and a regional nerve block. When you wake up, you will not be in pain and will be able to walk on your foot right away.

  • Osteotomy is a common type of bunion surgery that involves the surgical cutting and realignment of the bones around your big toe. Your orthopaedic surgeon selects the appropriate surgical procedure based on the type of bunion and its severity.

There are 3 main types of osteotomies used by foot and ankle surgeons; namely akin osteotomy, chevron osteotomy, and scarf osteotomy.


 

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