I am concerned about getting treatment for bunions
(hallux valgus)

Is surgery the only way to treat bunions?

Early and mild bunions may respond to the application of splints or braces, although the effects are often short-lived. Wearing 'corn plasters' or 'pads' may relieve local pressure symptoms. Shoes may be made or adapted to accommodate the bunion within a broad front (toebox). Some bunions are caused by a flat foot and collapse of the arches and these can be helped by arch supports. However, more severe bunions can only be corrected by surgery. Surgery is generally only undertaken if the symptoms are significant and all appropriate non-operative management has been considered. The surgery is usually carried out under general anaesthesia, with a local anaesthetic block used for post-operative pain relief. Surgery is usually performed either as a day case or with an overnight stay in hospital.

The osteotomy operation – Scarf / Akin or Chevron / Akin

An osteotomy is an operation in which a bone is cut, the parts of the bone realigned and fixed with either screws or staples so the toe lines up straighter. The particular type of osteotomy required will depend on the type of bunion being corrected.

What can I expect after the operation?

After the operation, you will wake up with your foot in a bandage. The foot can be painful (often not, due to the local anaesthetic blocks used) but painkilling tablets usually control this. In order to minimise swelling you will need to keep your foot up after the operation. You will be given a special protective shoe to wear after surgery.

What can I do once I am discharged?

To start with you will need to rest with your foot up most of the time for the first 2 weeks. If the foot is lowered, it will throb and swell; this may compromise the healing process and should be minimised. The foot must also be kept dry. Early movement of the toes, within the bandages, is encouraged. Around two weeks after surgery, you will return to the clinic for the removal of stitches (or a wound check, if dissolvable sutures are used). At this point, it is important to exercise or mobilise the toe and medical staff will advise on appropriate exercises. Failure to exercise increases the risk of developing stiffness of the toe after surgery.

On average, you should expect to spend six weeks in the post-operative shoe. After this you will need an open-toed sandal or loose fitting trainer. It will be a further six to eight weeks before you can wear a shoe for a working day, and it is usually three to six months before you can hope to resume recreational walking or light sporting activities. If your progress is slower than this do not panic – these figures are only averages.

What potential complications are there from bunion surgery?