What is bunion surgery?
Bunion surgery is a surgical procedure to remove bunions, which are bony lumps on the side of the foot at the base of the big toe (see figure 1). Successful bunion surgery can reduce the discomfort and pain bunions cause.
What causes bunions?
If you see a bony bump near the base of your big toe you may have a bunion. Anyone can develop a bunion, but they seem to be more common in women than in men(1) . This may be down to certain types of footwear, especially if there isn’t enough width to fit the toes in their natural position.
Bunions are occasionally associated with arthritis of the joint at the base of the big toe. Genetics can also play a factor; there is an increased risk of developing bunions if someone in your family has them. Other potential causes include conditions such as cerebral palsy, Marfan syndrome or gout.
Why would you need bunion surgery?
If your bunion isn’t causing you pain, then you won’t need to have surgery. However, if there is no improvement from non-surgical treatments, such as bunion pads or insoles, surgery could be considered.
Another indicator for surgery is if you have significant foot pain that restricts your daily life. You may find walking difficult and even wearing certain shoes may become problematic.
Also, if you’re experiencing pain, inflammation and swelling that doesn’t improve with medication, then surgery may be required.
What are the benefits of a bunionectomy?
There are several benefits to bunion surgery. Not only will your foot be corrected and your bunions removed, but you should no longer experience pain and will be more able to get back to your daily activities.
Following surgery, your big toe should be straighter, so your foot should fit more comfortably in a normal shoe.
Essentially, the aim of this operation is to relieve you from pain and improve your quality of life.
What does the operation involve?
Surgery is usually performed under general anaesthetic, however a variety of anaesthetic techniques are possible. The surgery itself may involve removing the bunion, releasing or tightening ligaments, cutting and realigning the bones of your big toe, and straightening one or more of your smaller toes.
Your surgeon may fix the toes in place with wires or tiny screws.
The operation usually takes between half an hour and an hour.
What complications can happen?
Any surgery can cause potential complications such as; bleeding, infection in the surgical wound, unsightly scarring, blood clots, difficulty passing urine and pain.
Specific complications of bunion surgery are:
- Damage to nerves around the big-toe joint
- Problems with bone healing
- Loss of movement in the big toe
- Severe pain, stiffness and loss of use of the foot (Complex Regional Pain Syndrome)
- Pain in the ball of the foot
- Recurrent deformity
- Your consultant will discuss all risks with you in full before your procedure.
How long does it take to recover?
The surgery is usually a day procedure, so you should be able to go home on the same day, unless instructed otherwise.
During your first week of recovery you will need to keep your leg raised in order to reduce swelling. In the first six weeks or more your foot and ankle will be swollen so you might need to wear special shoes. You should have realistic expectations about your surgery and it's important to be aware that it can take up to six months to make a full recovery.
Physiotherapy is a key part of your recovery. Specific physiotherapy exercises will help to improve the strength of your foot and increase your range of motion. These exercises are important as they will help you to return to normal activities as soon as possible. Before you do any exercise at all, you should ask a member of the healthcare team for advice.