Bunion surgery

What are bunions?
With a bunion, the base of your big toe (metatarsophalangeal joint) gets larger and sticks out.  As a result, the skin over it usually gets red, tender and inflamed. Wearing tight shoes then becomes painful especially with walking.  As the deformity progresses, the big toe angles towards the second toe, often undermining it and causing a hammertoe deformity.  The skin on the sole of your foot may become thickened and painful too and if untreated, the pain may become chronic and arthritis may develop.

Why don’t people get them treated?
Years ago, people had to undergo painful surgery to ‘remove’ bunions and endure up to a year of rehabilitation before they could wear normal shoes again. Now with modern surgical techniques available, bunion surgery is performed as a day case procedure and there is no need for plaster immobilization. Patients are up walking on the same day of surgery with a heel weight-bearing shoe fitted over their dressings. The majority of patients nowadays are surprised how little post-operative pain they have with the use of local anaesthetic pre-emptive analgesic blocks during the surgery.

What causes bunions?
It’s not clear what causes bunions but they usually run in families and there appears to be a hereditary predisposition to developing them. It’s generally believed nowadays that certain shoes such a high heels may not actually cause bunions but merely make the symptoms worse.

How do I know if I need bunion surgery?
If you already have a bunion, wear accommodating shoes and try protective pads to cushion the area. However, if your bunion has progressed to the point where you have difficulty walking, or experience pain even when wearing sensible shoes, you may need surgery. The best way to find out is to speak to a doctor.

What happens during bunion surgery?
A bunion operation realigns bone, ligaments, tendons and nerves so your big toe can be brought back to its correct position.  Little screws and staples hold the new bone positions.  Now thanks to modern techniques, we can perform the surgery as a day case procedure.  A successful bunion operation reduces discomfort and pain and the realignment of the big toe allows your foot to fit more comfortably in normal shoes.  Several different operative techniques are available depending on bony angles seen on weight-bearing X-rays.

What will happen if I don’t get my bunions treated?
They may progress and the symptoms may worsen. A progressing bunion may be associated with pain and deformity of the second toe, metatarsalgia and osteoarthritic changes. However, you should speak to a doctor for an expert opinion.

Did you know?

  • 15% of women in the UK suffer from bunions according to The College of Podiatry
  • Nine out of ten bunions happen to women
  • Half the women in the UK suffering from bunions don’t seek treatment
  • Bunions are more likely to be hereditary than caused by high heels
  • Bunion surgery can now be performed as a day case with patients walking out of the hospital the same day.

Acknowledgements: Mr Alex Watson 

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