Mr Mark Davies, Consultant Foot & Ankle Surgeon answers the FAQs about Bunions
Mr Mark Davies, SOL Consultant Orthopaedic Foot & Ankle Surgeon
Claremont Clinics: Wednesday AM and Thursday AM
What is a bunion?
A bunion is a deformity of the big toe. Rather than being as a result of an excess growth of bone, it occurs because the big toe drifts away from the centre of the body at the same time as the first metatarsal bone deviates in the opposite direction. This creates the characteristic “bump” at the base of the toe. As the deformity progresses, the smaller toes are often affected becoming bent and clawed accompanied with pain under the ball of the foot.
What causes the bunion and why does it hurt?
It is very common to find that most bunion deformities through family trees. Ill-fitting footwear is more likely to make the problem worse, particularly fashionable pointed shoes with a higher heel. The pain is seldom due to the joints of the big toe becoming arthritic and pains either occur from bunion rubbing on the shoes or from the forces of body weight stressing a bent toe. Other pains related to the bunion can be due to the smaller toes deforming and the development of hard skin on the sole of the foot.
Does my bunion require surgery?
The symptoms from the bunion can be treated by wearing wide-fitting, soft upper shoes without a heel. It is worthwhile having a healthcare professional fit an insole to your shoe as this can also alter the forces passing through the big toe. Splints to straighten the toe may provide some relief of symptoms but will not reverse the deformity. In reality, the bunion deformity can only ever be corrected by surgery but surgery should only be considered once all other measures have failed to resolve the pain. An important point to note is that surgery is not indicated for the cosmetic appearance of the foot alone.
What does bunion surgery involve?
Bunion surgery is undertaken after careful planning with your surgeon. This includes X-ray assessment of your foot whilst you are standing up. Orthopaedic Foot & Ankle surgeons work closely with anaesthetists to provide safe, day case surgery using methods of anaesthesia to suit each individual. Antibiotics are routinely administered to lessen the chances of infection. The type of surgery depends on the amount of bunion deformity but routinely involves releasing ligaments and cutting the first metatarsal and proximal phalanx bones to re-align them. The repositioned bones are then fixed with screws and staples. When the smaller toes are affected, they can be treated at the same time as the bunion. The whole operating time is usually between 30 to 60 minutes.
What is the recovery time after surgery?
Dressings and bandaging are applied after the surgery. A surgical shoe is fastened with Velcro straps to protect your foot for the first 6 weeks after surgery. It is extremely important to rest the foot completely for the first 2 weeks to allow the surgical wounds to heal. At 6 weeks post-op, expect to start returning to loose-fitting shoes with a return to most normal shoes at 3 months after the surgery. The swelling after the surgery takes up to 6 months to fully settle.
When can I return to work and sports?
This is dependent upon the type of job and sports undertaken. Most people who are on their feet at work all day need 8 to 10 weeks away from these duties. Most sedentary, desk-based work may resume much sooner as advised by the surgeon. Most people try to resume training for sports at about 3 months from the operation date.
Are there risks and complications from bunion surgery?
Any risks or complications will be discussed in advance of your treatment with your expert Consultant. The vast majority of patients are delighted with their surgery (95%). For the experienced Orthopaedic Foot and Ankle surgeons at Claremont Private Hospital, the other risks of leaving a residual bunion deformity or over-correcting the toe are very rare. These surgeons continue to perform a procedure that has stood the test of time and reduces the chances of recurrence of the deformity over time.
A private consultation with Mr Davies at Claremont is £200 if you don't have health insurance. To book an appointment, call our friendly Private Patient Team on 0114 263 2114 or email firstname.lastname@example.org. You will need a referral letter from your GP or you can see one of our Private GPs if you prefer.
Copyright M Davies, August 2018.