Bunion – Hallux valgus

The cause of a crooked big toe with bunion formation is unsuitable footwear or a hereditary condition. Often, however, it is a combination of the two. The condition affects women more often than men.

In some cases, bunion formation is also caused by a problem higher up in the foot, which is why a weight-bearing X-ray of the foot in question may be taken as part of the preliminary examination. Based on the X-rays, if surgery is chosen, the surgical technique best suited to solving the problems is selected.

There is only reason for treatment if there is pain. If the discomfort is mild, surgery should be postponed and an attempt made to adjust footwear to foot-shaped shoes, which is also necessary after surgery.

Symptoms of bunion

The symptoms are pain, swelling, possibly problems with fitting footwear and the development of sores.

Examination

You will be examined by one of our orthopaedic surgeons, who will ask thoroughly about your problems. An X-ray of the foot is necessary. The diagnosis is made on the basis of the medical history and the findings of the clinical examination. An ultrasound examination of the foot can optionally be added to rule out other conditions.

Treatment of bunion

Surgery is not always necessary. There must be pain and daily discomfort for it to be considered. Most often, a change of footwear or insoles is the first thing to try.

During surgery, the metatarsal bone at the big toe is cut across so that the bone can be straightened and then locked again with a screw or a strong suture/thread (Chevron osteotomy).

Depending on the misalignment, it may be necessary to make the cut higher up on the metatarsal bone (proximal osteotomy) or to stiffen the joint between the metatarsal bone of the big toe and the cuneiform bone. In addition, it is often necessary to perform a straightening on the big toe itself (Akin) or other supplementary procedures.

The operation can be performed with different types of anaesthesia. This is agreed with the anaesthesiologist. 1-2% may experience complications in the form of infection or poor healing of bone or skin. In addition, there is a small risk of developing a blood clot in the veins of the leg.

Around 15% of patients do not feel that they have achieved a result that lived up to their expectations, often because there is still a degree of pain, or because the misalignment has re-established itself despite a successful operation. Swelling and a certain tenderness of the forefoot may occur for 3-6 months. You go home the same day and must keep the leg raised high for the following day. You will be fitted with a heel shoe as well as a large forefoot bandage, possibly a walker boot. You must walk with this for 5-6 weeks. Afterwards, gait over the forefoot can typically be allowed. In some cases, further outpatient check-ups are arranged. The stitches are typically removed after 2-3 weeks at an outpatient follow-up appointment with the surgeon.

If you have a sedentary job, sick leave for 10-12 days is realistic, but if your job involves a lot of walking (e.g. craftsman, nurse etc.), you should expect sick leave for 6-8 weeks or more depending on the type of operation.