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What is a Bunion?

A bunion (Hallux Valgus) is a prominent inner (medial) bony prominence at the big toe. This is due to the angulation of the big toe towards the 2nd toe. Many people have a bunion which does not cause pain or difficulty with shoe wear. Those can be observed only. If the bunion causes pain or problems with shoe wear, you might want to consider surgery.

 

What are the treatment options for a bunion?

Conservative treatment involves strapping, pain medication, orthotics and shoes with a wide toe box. This however does not prevent progression of the bunion.

Minimal invasive surgical treatment involves tiny bone cuts (osteotomies) to realign the toe and remove the bunion.

 

How long is the recovery after bunion surgery?

You will be able to walk in a special shoe immediately after the surgery. The 1st 2 weeks your foot must be elevated (lifted to above the level of your heart) to minimize swelling and allow wound healing. As a rule, you should keep the foot up 45 minutes out of every hour. You will progress into your normal shoes between 3-6 weeks.

 

When can I start driving again?

You can start driving again usually between 3 to 6 weeks.

 

What are the risks and complications of bunion surgery?

  • Wound problems: There is a small risk of wound bleeding or infection. For this reason, you will keep your foot up until the wounds heal. Deep infection requiring further surgery is very rare.
  • Stiffness and swelling: Stiffness and swelling is normal and can persist up to 1 year after surgery. Early physiotherapy is important.
  • Nerve injury: Often you may experience numbness or pins and needles around the foot from working close to the nerves. Permanent injury is rare and most of the time this resolves over a few weeks.
  • Bone healing: The bone cuts (osteotomies) sometimes do not heal/knit together (unite) or take longer. This is more common in people who smoke.
  • Recurring bunion: The bunion can recur sometimes. This is less common and might require another operation.
  • Over correction (Hallux Varus): Rarely after the bunion operation the toe might drift too far away from the 2nd toe and might need another operation.
  • Complex regional pain syndrome (CRPS): This is a rare complication after hand or foot surgery where the nerves have an abnormal response. The brain experience normal touch as pain. This can cause distress and discomfort and prolong recovery. Other symptoms can include swelling, skin colour and temperature changes and change to hair and nail growth. Treatment includes pain medication and occupational therapy and should be started early.
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