We use the term bunions to describe a swelling on the side of the big toe joint.  This is a little lazy as the swelling is only a small part of the underlying problem - the true term that we should use is hallux valgus.

In hallux valgus we see that the big toe (hallux) moves towards the second toe and further back inside the foot the first metatarsal bone moves away from the other metatarsals.  The two small bones called sesamoids (which are like your knee cap) also move out of position.  As well as the bone displacement we see that the tendons and ligaments which surround the joint lose their supporting functions, which will result in a poorly functioning first toe joint.  Over time the joint loses its stability and becomes prone to arthritic change as well as causing other effects on the foot such as hammer toe deformities and metatarsalgia - a pain in the ball of the foot.

It is therefore important when considering surgical correction to fully understand the steps that are needed to achieve this.  Rarely is it advisable to merely take off the bump on the side of the foot as this will create more instability.  Whenever possible the underlying bone deformity must be addressed whereby the bones are cut and repositioned  into a better, more functional position (a metatarsal osteotomy) to allow the joint to give better function.  Once this is achieved then the soft tissues can be placed back into proper alignment.

The aim of bunion surgery, like the majority of foot surgery, is to achieve a pain free foot which not only looks good but which works well.

After surgery the foot is supported by heavy dressings of gauze, wool and crepe, which will be left in place until your next outpatient appointment. DO NOT get the dressing wet or remove it as this will increase chances of post-operative complication.

To heal well your foot will need rest and elevation, particularly in the first 48 hours.

• Keep the foot elevated for 48 hours.  Only do the minimum activity.
• Elevate your foot above your hip level, one or two pillows is usually the correct height.
• Use ice on the front of the ankle for ten minutes every hour.
• Use your painkillers as instructed.
• Always use the post-operative shoe and crutches (provided by hospital) when mobile.

When your foot settles be as active as the foot will let you, keep the weight away from the front of the foot until you feel comfortable, this will usually take at least one week.

- Getting better after surgery

- Complications

- Post Operative Advice

- F A Q

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