Bunion (Hallux Valgus)

Presentation

Patients will have a prominence on the inner side of their foot, often associated with redness and pain. The big toe deviates laterally. The deformity usually becomes progressively worse with time. Patients may also experience pain under the ball of the foot (transfer metatarsalgia).

Investigation

Your GP should initially request these investigations:

Weight bearing foot X-ray (AP, oblique and lateral)

Your surgeon may also request the following investigations for more information or surgical planning:

No other investigations are usually required

Conservative Treatment

Initial treatment of Bunion (Hallux Valgus) could include:

Accommodative footwear with a wide toe box. Orthotics may also relieve discomfort, especially if the patient has metatarsalgia.

Surgical Treatment

Surgical treatment of Bunion (Hallux Valgus) includes:

Scarf + Akin osteotomy

• Incision along medial border of great toe Metatarsal bone is cut with saw, repositioned and held with screws
• Wedge of bone removed from proximal phalanx and correction held with staple
• Bony prominence removed
• Wound closed with non-absorbable stitches
• Foot bandaged to reinforce position and placed in Darco MedSurg flat shoe

Condition specific risks include:

1. Malunion
2. Non-union
3. Hallux varus (over-correction)
4. Metalwork failure

General risks of surgery include:

1. Infection
2. Damage to nerves/blood vessels
3. DVT / PE (blood clots)
4. Anaesthetic risks

Recovery

Recovery from Bunion (Hallux Valgus) surgery will include:

• Keep foot elevated as much as possible, especially for initial 72 hours
• Keep dressings dry and intact until post operative appointment.
• Pain killers may be required for up to 2 weeks.
• Removal of stitches: 10-14 days at first post operative appointment.
• Protected weight bearing for 6 weeks:
  • post operative flat DARCO shoe.
  • crutches as required.
• Recommencement of most activities: 12 weeks. Full recovery: 3-6 months.

Every patient’s recovery is individual and depends on the severity of the injury and the complexity of the surgery.