Bunion surgery is a treatment for bunions to relieve pain and improve function. There are a few types of bunion surgery, sometimes called bunionectomy. They typically involve repositioning your big toe.

You should see a doctor about a bunion if you have:

big toe or foot pain that has not improved over a few weeks after home treatments
pain that is stopping you from doing your normal activities and makes walking difficult
a visible bump on your big toe that is getting worse
decreased movement of your big toe or foot
difficulty finding shoes that fit properly because of your bunion
diabetes as well – foot problems can be more serious for people with diabetes

There are different techniques involved in bunion surgery, that can include:

taking away the swollen tissue around your big toe joint
removing part of your big toe bone to straighten it
realigning one or more forefoot bones to a more normal position and correcting the abnormal angle in your big toe joint
permanently fusing the bones of your affected toe joint.

Because bunions vary in shape and size, there are different types of bunion surgery to correct them. The different bunion surgical procedures include:

Keyhole bunion surgery - minimally invasive surgery involves performing bone cuts through small skin incisions, whilst open, as the name suggests uses a larger incision.
Osteotomy – is the most commonly performed bunion surgery. It involves cutting away your bunion and repositioning your bones with metal screws to straighten your big toe and reduce the bump on the side of the foot.
Exostectomy – is rarely performed and just for the most minor bunions. It involves your surgeon shaving off your bunion. It is often combined with an osteotomy to reposition your toe.
Arthrodesis – is only performed on severe bunions. Your surgeon removes any parts of your big toe joint that have arthritis and then places screws in the toe to hold the bones together while they heal.

The alternatives to bunion surgery are non-surgical treatments. They won’t get rid of your bunion but they will relieve the pain and may help to prevent them from getting worse.

These can include:

simple pain killers and prescribed medications
bunion padding and taping - to alleviate your discomfort, keep your foot in a normal position, and take pressure off your bunion
holding an ice pack to your bunion for up to five minutes at a time
footwear adaptations - the addition of orthotics such as insoles, toe spacers, or toe splints at night can help. These can be bought at a pharmacy or through your podiatrist who may also offer you some guidance
steroid injections – that comprise a local anaesthetic and corticosteroid medication can temporarily treat bunions by relieving discomfort and reducing inflammation
avoiding high-heeled, tight, pointy or ill-fitting shoes. It is advisable for you to choose shoes that are wide, have a low heel, and are made of soft leather
try to lose weight if you're overweight.

Bunion surgery is used to treat severe bunions that are causing significant pain and affecting your quality of life. It is usually recommended if you’ve tried other more conservative bunion treatments.

Your doctor will assess your bunion and discuss treatment recommendations. Typically, you will need bunion surgery if your bunion is painful or causing functional problems. Problems that would indicate bunion surgery include:

a big toe that points and drifts toward your smaller toes
a stiff big toe, called Hallux rigidus
big toe pain that is interfering with your daily activities
ongoing swelling and inflammation of your big toe.

Surgery is the only way to get rid of your bunion. Bunion surgery straightens your big toe and removes the painful prominence. It also aims to prevent a bunion reoccurring.

You should benefit from: reduced pain, walking easier, and being able to find shoes that fit your foot comfortably.

Removing a bunion also reduces your risk of bunion complications that can include bone spurs, bursitis, hammertoes and osteoarthritis.

Your surgeon will consider the severity of your bunion, your general health, activity levels and age, and any medications you take. They may request a foot X-ray to help them clearly see the deformity in your foot and to decide where along the bone to perform surgery. Your surgeon will discuss your surgery with you and what you are to expect.

Bunion surgery can be performed under local, general or spinal anaesthetic. Before surgery, you will be given an anaesthetic. If you decide to have a general or spinal anaesthetic, your doctor will advise you when to stop eating and drinking. You should also arrange a lift home and for a friend or family member to stay with you for 24 hours.

It is also a good idea to prepare your home for when you return after surgery as you may find it difficult to move around at first, especially if you are using crutches. This may involve rearranging some furniture to make access easy and moving items so you can reach them without difficulty. If your home has stairs, you may choose and prepare to sleep downstairs.

Your podiatrist or orthopaedic foot surgeon will perform your bunion surgery. Bunion removal surgery typically takes less than an hour and you should be able to go home the same day. There are a number of different types of bunion surgery and the type of operation will be based on the severity of your deformity. Metatarsal osteotomy is a common bunion surgery.

Before surgery you will be given a general, local or spinal anaesthetic. Your surgeon will make a cut over your big toe joint on the inner side of your foot or, make several small incisions around your big toe joint.

Bunion surgery usually involves cutting and removing part of the bone in your big toe to correct its alignment. Additionally, soft tissue around your big toe may be repaired, your ligaments may be released or tightened and, your smaller toes straightened. Pins, plates, or screws may be used to hold everything in place.

Your foot will probably be in a bandage and this will need to be kept dry. Often patients are given crutches or a brace and a special post-operative shoe to wear to protect your foot. You will be advised about how much weight you can place on your foot.

You can expect mild pain for the first 48 hours. This can be treated with painkillers.

It is important to keep moving your toe to keep it flexible.

For the first couple of weeks, you should rest with your foot up to help reduce any swelling.

You will be able to drive again when you can wear a normal shoe again and you can safely do an emergency stop. First, you should check with your surgeon and car insurance company.

Three to six months after bunion surgery, you can return to normal walking or sports activities.

The type of job you do will determine how quickly you can return to work. If you sit down most of the time, you may be able to go back after six weeks. If your job is more physically demanding, you may need to be off work for up to 12 weeks.

You must follow your surgeon’s post-operative advice. We will arrange a follow-up appointment to check on your recovery.

Your doctor will discuss the risks or complications of bunion surgery with you. They are rare, and are usually easy to treat but may prologue your recovery. The risks of bunion surgery include:

infection or inflammation at the wound – that require antibiotics
nerve damage – causing a numb toe
continued pain or stiffness – if there is a change in your weight distribution then you may feel pain under the ball of your foot. You may also experience a stiff toe
an abnormal toe position – your big toe may heal outwards, upwards or be slightly shorter.

This is a day case procedure so typically you’ll go home the same day. You should stay off your feet as much as possible for at least two weeks. You’ll be advised to wear a post-operative shoe that protects your foot and you may need crutches or a brace. You must follow your doctor’s post-operative advice.

The time it takes to recover from bunion surgery will depend on the exact surgery you had.

Typically, it will take around three months to heal after bunion surgery and you’ll usually need to avoid driving and stay off work during this time. Normally you are advised to avoid sport for six months. You should ask your surgeon about your recovery based on your individual circumstances.

The cost of your bunion surgery for one foot will depend on the severity of your bunion, the exact bunion treatment required, and your chosen Ramsay hospital.

If you decide to pay for your treatment, Ramsay offer an all-inclusive Total Care package, where a single one-off payment at a pre-agreed price, delivering direct access to all the treatment you need for complete reassurance. You can also spread the cost of your treatment with finance options available.

Bunion surgery may be covered by your medical insurance policy. We advise you to check directly with your insurance provider and get written confirmation before commencing treatment.

Ramsay Health Care hospitals offer a range of bunion treatments including bunion surgery to relieve your pain and help you to walk more comfortably. We have expert podiatrists and orthopaedic surgeons with a special interest in feet who can recommend and discuss in detail the best bunion treatment for your needs.

You can rest assured that our surgeons regularly perform bunion surgery and that they will take every care to achieve the best results to remove the deformity and restore your foot function.

Fitzwilliam Hospital Specialists

Mr Tejinder Bhullar

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