Bunion surgery - osteotomy for hallux valgus

If you would like to know about the symptoms and diagnosis of bunions, and about bunion treatment, the following information will interest you.

If you are considering having bunion treatment - a bunion operation -  or have bunions surgery planned, it will be useful to know all you can about it. This includes:

• why you need a bunion operation

• what it will be like

• how it will affect you

• what risks are involved

• any alternatives to bunions surgery.

The information here on the subject of bunion surgery is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things when carrying out bunion treatment, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your bunion treatment choices with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.

What is the problem?

You have a combination of two problems. You have developed a bunion, and your big toe is going towards your second toe, called hallux valgus. Bunions can appear on both feet.

What is a bunion?

A bunion refers to the prominent bump on the side of the joint at the base of your big toe. It can make finding comfortable shoes difficult. The bump on your toe may be red and sore.

What has gone wrong?

Bunions can run in families with certain foot types, or may be caused by arthritis, nerve conditions, foot injuries or other conditions that result in abnormal weight distribution in the feet. It is also suggested that tight-fitting, high-heeled and narrow-toed shoes may increase the risk of bunion formation. Bunions are more often seen in women than men and become more common with age.

The aims

The aim of the operation is to straighten your big toe and reduce the size of your bunion.

The benefits

The main benefit is to reduce the pain from your bunion. By straightening your toe and narrowing your foot, it will be easier to find comfortable footwear.

Are there any alternative treatments?

Before bunion surgery is considered, non-surgical approaches or conservative care should be tried. You could wear extra-wide special shoes or you can use a splint. Splints hold the big toe straighter but they do not fix the problem and the toe will not remain straight when you are not wearing the splint.  Anti-inflammatory medications can be of help to reduce pain and swelling, and simple painkillers can relieve the pain. Physiotherapy will not help.

What if you do nothing?

Your big toe will bend further towards your second toe and may even overlap it.

Who should have it done?

Most people try bunion pads from the chemists or the chiropodists before considering surgery. If the pads do not help and your toe is still painful then you should have your big toe straightened.

Who should not have it done?

You should not have a general anaesthetic if you have major medical problems, such as high blood pressure or a bad heart. It is possible to do the operation under a regional anaesthetic. 

You should not have the operation simply to make your feet look better.

Author: Mr Boyd Goldie MBBS FRCS BSC DHMSA. Consultant in orthopaedics & trauma.

© Dumas Ltd 2006

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