An Overview: Hallux Valgus (Bunions)

Hallux Valgus (Bunions)

Overview

These are a common problem affecting millions of people worldwide. They are thought to occur due to a muscle imbalance that is often inherited. Wearing the wrong kind of shoes, especially shoes that are too tight or small, may exacerbate the problem however this is not the actual cause. Bunions get worse with age and can eventually cause pain and deformity. It may also result in damage to other parts of your feet. You feel pain from bunions because of their size and their abnormal biomechanics.

Process

Many operations have been tried over the years but the one with the highest success rate and used at Sunshine Coast Orthopaedic Group is the Scarf and Akin osteotomy. The key to its success are that it restores foot mechanics and allows the early return of joint motion. The recurrence rates are also low.

The procedure has 5 components performed through 2 incisions. Initially, one of the tight ligaments and the tight muscle are released and the bunion is shaved. The metatarsal bone is cut and adjusted to narrow the foot and realign the joint and 2 small screws are placed in the bone to fix it solidly. Following this a wedge of bone is removed from the phalanx bone to straighten the big toe and a small staple or screw is used to hold the bone in place. The joint capsule is tightened and the skin is closed. The metalwork does not usually need to be removed. The procedure is performed under general anaesthetic along with a nerve block which puts the foot to sleep for around 12-18 hours.

Plaster is not required as the toe is held in place with a bandage for 4-6 weeks. As with all surgery some swelling occurs. This may limit your activity and choice of footwear. Swelling can increase initially then subside as your toe heals. You can take simple oral pain relief as required.

Recovery Times

The final result can be expected 3 months after surgery but your body may continue to adapt for up to 12 months. Wide shoes will have to be worn for up to 12 weeks.

Hospital stay	1 night
Rest & elevation	10 days
Crutches/frame	1-2 weeks
Foot swelling	12 weeks

Time off work

Seated	3-4 weeks
Standing	6-8 weeks
Lifting/carrying	8-12 weeks

Benefits

Relieves painful symptoms
Allows return to physical activities
Allows patient to wear normal footwear

Risks

No surgery is risk free. Please be aware of the following:

Infection
Blood clots
Reaction to the anaesthetic
Recurrence of the deformity
Overcorrection of the big toe
Problems with bone fixation
Numbness or hypersensitivity of the toe