Bunions can be treated both conservatively (non-surgically) and surgically.
A bunion is a structural deformity of the big toe joint. The medical term is Hallux AbductoValgus- where the Hallux (big toe) Abducts (moves towards the lesser toes and moves into a Valgus position (rotates). It appears as if there is a bump growing out of the foot at the big toe joint, but it is actually the metatarsal head subluxating or dislocating. The big toe drifts of towards the lesser toes in response to this and can cause the lesser toes to elevate, buckle or hammer as a result. A bunion is often painful as well as cosmetically displeasing and is a progressive deformity.
If a bunion deformity is left untreated the bump (medial eminence) continues to enlarge as the joint continues to sublux, the big toe continues to drift towards the other toes and often will cause secondary hammering of the lesser toes firstly affecting the second toe along, then the third, fourth and fifth. The longer the joint is maltracking the more likely it is that the joint will degenerate. This degeneration is the wear and tear we commonly know as arthritis or osteoarthritis. Once the joint starts to degenerate other effects like joint swelling and pain are more likely to progress and become more debilitating as well.
Bunions can be treated both conservatively (non-surgically) and surgically. Conservative options include padding, cushioning, splinting, joint injections, accommodating with footwear and even orthoses if secondary to foot mechanics. None of these treatments will straighten the toe, but they can be effective in controlling symptoms, and sometimes slowing the progression. Surgical options may sometimes include reshaping the “bump” but generally speaking the joint needs to be realigned, so it involves cutting the metatarsal bone and rotating it back into the foot and pinning it into place.
Bunion surgery is performed as day surgery under local anaesthetic, sedation or general anaesthetic depending on the extent of the deformity and patient preference. The “bump” will be reduced but more importantly the joint will be realigned so that it can track properly again instead of wearing unevenly. There is often soft tissue involvement and tendons and capsular changes that are contributing need to be addressed at the same time to minimise the chance of recurrence. Any hammertoes can be addressed at the same time if they exist.
You are able to go home on the day of surgery as it is day surgery. You will be expected to keep your foot elevated for the first two weeks, although you will be able to walk in a protected capacity with a surgical shoe and crutches to assist you. After two weeks you can generally start returning to trainer style footwear for the next 2-6 weeks as you start to return to normal activity levels. By two months you should be walking normally, and by three months there should be no limitations on your activity levels.
Disclaimer: Individual results may vary. Surgery and all health regulated services may carry some risks which you can discuss with our doctor.
Most concerns have more than one course of treatment. Feel free to contact us so one of our team can discuss options for your unique concern.