What are bunions and why do they develop?A Bunion (Hallux Valgus) is a bony prominence that develops around the joint beneath the big toe. Bunions can restrict movement, choice of footwear and can be very painful.
What does a Bunion look like?Bunions progress over time, starting as a mild ‘bump’ and developing until the toe dislocates, often overlapping the adjacent lesser toes.
Bunion treatmentsThere are many ways that you can treat the symptoms caused by Bunions and prevent progression. However, the only way to fully correct the deformity is with surgery.
When is Bunion surgery recommended?Non-surgical treatments are attempted before surgery is advised. However, if conservative measures fail, your specialist may recommend bunion surgery.
What are the alternatives to Bunion surgery?There are alternatives to treating Bunions surgery, though these will aim to treat the symptoms rather than correct the underlying problem. These might include:
- NSAIDS – to manage painful episodes
- Appropriate Footwear – which does not put undue pressure on the big toe joint and has sufficient room in the toe box
- Toe Splints – the can help keep the toe in correct alignment but do not correct the bunion deformity.
Types of Bunion SurgeryAt our clinic the four most common types of Bunion Surgery include:
The scarf and akin osteotomy is a common procedure carried out to correct a bunion. It is used to correct moderate bunions and allows for early weight-bearing due to the titanium screws used and the stability of the bone following surgery. Your bunion surgeon will start by making an incision on the inner side of the big toe joint and release the tight ligaments that are holding the toe out of alignment. The bump will be removed and the metatarsal and big toe proximal phalangeal bones will be realigned to a corrected position. Titanium screws are used to fix the toe in position and allow predicted correction and excellent stability.
RecoveryOver the first two weeks you should rest at home whilst elevating your foot as much as possible. You will be able to slightly increase activities at one week, but should still rest at home. You’ll be able to start wearing trainers at two weeks and return to high impact activities at six-eight weeks following surgery.
Minimally Invasive Surgery, also known as Keyhole Surgery, uses specialised techniques and equipment to reduce the size of incision and soft tissue interruption during a bunion operation. This can help reduce the overall recovery period, postoperative pain and scarring. There are several minimally invasive surgeries available, our bunion surgeon, Mr Kaser Nazir, favours the PECA bunion correction system. This technique involves only three-four 2mm incisions. 3-4 PECA screws are used to stabilise the bone.
RecoveryOver the first two weeks you should rest at home whilst elevating your foot as much as possible. You will be able to slightly increase activities at one week, but should still rest at home. You’ll be able to start wearing trainers at two weeks and return to high impact activities at eight weeks following surgery.
Traditional bunionectomy is typically reserved for for very minor bunions in elderley patients where the bunion bump is the main concern and the alignment operation is not suggested due to osteoporosis, poor health or frailty. An incision is made to the inner side of the big toe. The bony bunion growth is then removed, no pins or screws are used during the procedure.
RecoveryThe patients can mobilise very early with this procedure. Elevation of the foot is required for a couple of days and wound healing will typically take 2 weeks.
The lapidus bunion procedure is typically carried out for severe bunions or for patients who are hypermobile where there is a significantly higher chance of the bunion recurring after more traditional surgeries. The procedure involves mending of two bones towards the arch of the foot. An incision is made to the top or side of the foot. The bunion bony growth is then removed. The joint near the instep (tarsometatarsal joint) is realigned and fused with a fixation such as screws, plates and/or implants.
RecoveryYou should rest at home for the first two weeks and elevate your foot as much as possible. At two weeks following the surgery you will be transitioned into an Aircast boot for a further four-six weeks, you should be able to stop using crutches at four weeks postoperative and just mobilise with the Aircast boot. At three months following surgery you should be able to return to high impact activities, such as the gym and running.
Preparing for Bunion surgeryYour Consultant will recommend a particular type of bunion procedure that is most appropriate for your case. You will be given information on the surgery and what to expect, which will allow you to make a decision on whether and how to proceed. There are several things to prepare before surgery. Some important considerations are:
- Let your family and friends know what is happening. This way you will benefit from support such as, checking in on you, helping perform certain tasks that might be hard and keeping you engaged and entertained.
- Prepare your house so that things you will need often are close at hand. This will reduce any need to move frequently. It is often a sensible decision to move your bed to the ground floor.
- Stock up on supplies, such as food and other necessities. This will decrease how often you will need to leave the house.
Bunion surgery before and afterFollow the below link to our gallery to see images of Before and After Bunion Surgery.
What to expect after Bunion surgeryTypically you can return home on the same day as the surgery. You will be given post operative instructions and advice on looking after the surgery site and what to expect while recovering. You will be reviewed at key stages postoperatively to ensure your healing is going as expected.
Bunion surgery recovery tipsPerhaps the most important advice to follow during the postoperative stage is the PRIE regime. This stands for:
- Protect – you will be advised on how to protect the area while recovering from surgery
- Rest – you will require considerable rest following surgery to allow the area to heal. There will be a very gradual return to activity
- Ice – Icing the area can help with pain and swelling
- Elevate – this will also help with swelling and pain and promote recovery
Average cost of Bunion surgery in the UKThe cost of Bunion surgery will vary across the UK, depending on a number of factors and the type of procedure that is recommended. At our clinic we offer guide package fees:
One Foot Bunion Procedure
Both Feet Bunion Procedures
One Foot Bunion Procedure
Both Feet Bunion Procedures