A bunion is a bony prominence that forms on the knuckle of your big toe, forcing it to press on the other toes. Its medical name is hallux
valgus and it can become extremely painful over time.
Bunions are a common problem and tend to get larger and more painful over time. Sometimes the pain can prevent you from doing normal, everyday things like walking. Bunions can also start to force your second toe out of place causing permanent deformity and pain.
What is the treatment?
These can help to ease the pain include:
- bunion pads
- shoe insoles
- ice packs
- wearing comfortable shoes.
However, if these haven't helped and the pain is preventing you from living a normal life, surgery to remove your bunion could be the right option for you. It's a relatively straightforward operation and for most people, the benefits of pain reduction are much higher than any potential disadvantages.
Bunion surgery is usually carried out under general anaesthesia, which means you will be asleep throughout the procedure, but sometimes local anaesthetic can also be used.
There are many different surgical procedures to remove a bunion, and your consultant will discuss which procedure is best for you, but one of the most common types is called an osteotomy. The first metatarsal bone will be cut, realigned and fixed with 1 or 2 screws in an improved position. In many cases the proximal phalanx will also need to be realigned with a second osteotomy, which will be fixed with either a screw or a staple. This is carried out under x-ray guidance during the procedure to achieve the best possible position.
If you have this kind of operation, which usually takes under 60 minutes, the surgeon will make a cut near your big toe to gain access to the bones and the joint. How this is done will depend on the severity of the bunion and its location.
After the operation your foot will be bandaged tightly and you need to wear a protective postoperative shoe for protection.
Another form of surgery is fusion (arthrodesis), which involves fusing two bones in your big toe joint together, but this is only used for patients who have bunions with osteoarthritis, patients with very severe deformities of the big toe joint or very elderly where the bone density makes realignment difficult or impossible.