Bunions (also known as Hallux Valgus) are a deformity of the big toe. The big toe deviates towards the second toe, altering the biomechanics of the forefoot. This produces a prominent metatarsal head (bunion) and, in some cases, a fluid-filled bursa. This can become a problem as the bunion then rubs against shoes, causing pain and further upsetting the bunion.
There are many theories why bunions occur and genetics, ill-fitting footwear and gender seem to be related to the development of the deformity. Due to the malalignment, the second toe can be affected developing into a hammer toe. Bunions may not cause any discomfort but might present with inflammation, swelling, pain and skin changes.
As long as bunions do not cause any pain, there is no increasing deformity or the second toe is not affected bunions do not need to be corrected surgically.
In milder cases, appropriate shoes, a little spacer between the toes and some “cushioning” might alleviate symptoms well enough but will not correct the deformity.
When the deformity is such that it causes increasing pain, one has difficulties finding any kind of comfortable shoes and one has the impression that the deformity is getting worse or even more so the second toe start to change shape and position, surgery has to be considered.
Generally, this means breaking the bone, resetting it and fixing it with metalwork in the desired position. There are many different methods which are successful, whether it is open or minimal invasive. The surgeon’s experience as often is crucial to make sure that the right operation for the right deformity at the right time is performed. Recovery does not vary much amongst different types of operations and one has to wear a stiff-soled post-op shoe for up to 6 weeks. One can always start full weight-bearing from day one and one does not need any crutches. Using modern state of the art technology and implants will provide a safe and full recovery in time.