Bunions, medically known as hallux valgus, are a common foot condition characterised by a bony bump that forms at the base of the big toe. While they may seem like a minor inconvenience, bunions can cause significant discomfort and impact mobility if left untreated. In this comprehensive guide, we’ll explore the anatomy of bunions, their causes, symptoms, surgical treatment options, and postoperative management and rehabilitation guidelines.

Anatomy of Bunions

To understand bunions, it’s essential to grasp the underlying anatomy of the foot. A bunion forms when the metatarsophalangeal (MTP) joint, (where the big toe bone meets the foot bone), becomes misaligned. This misalignment causes the big toe to angle inward toward the other toes, resulting in the characteristic bony protrusion on the side of the foot.

To understand bunions, it’s essential to grasp the underlying anatomy of the foot. A bunion forms when the metatarsophalangeal (MTP) joint, (where the big toe bone meets the foot bone), becomes misaligned. This misalignment causes the big toe to angle inward toward the other toes, resulting in the characteristic bony protrusion on the side of the foot.

X-ray Image of Bunion

Causes of Bunions

Bunions can develop due to a combination of genetic, biomechanical, and lifestyle factors. Some common causes include:

• Genetics: Bunions tend to run in families, suggesting a genetic predisposition to the condition.
• Foot Structure: Certain foot shapes, such as flat feet or low arches, can increase the risk of developing bunions.
• Footwear: Tight, narrow shoes that squeeze the toes together can exacerbate bunions or contribute to their formation.
• Foot Stress: High-impact activities or occupations that place excessive stress on the feet can also increase the likelihood of bunions.

Symptoms of Bunions

Bunions can cause a range of symptoms, including:

• Pain or tenderness at the base of the big toe
• Swelling, redness, or inflammation around the affected joint
• Difficulty wearing shoes due to discomfort or rubbing
• Corns or calluses developing on the bump or between the toes
• Limited range of motion in the big toe

Surgical Treatment Options

When conservative treatments such as orthotics, padding, or changes in footwear fail to provide relief, surgical intervention may be necessary. Bunion surgery, or bunionectomy, aims to realign the MTP joint and remove the bony bump. Common surgical procedures for bunions include:

Osteotomy:

This involves cutting and repositioning the bones to correct the misalignment of the big toe.

Exostectomy or Bunionectomy:

The surgeon removes the bony bump without altering the alignment of the toe joint.

Arthrodesis:

In severe cases, fusing the bones of the MTP joint may be necessary to provide stability and pain relief.

Postoperative Management and Rehabilitation

Following bunion surgery, proper postoperative care and rehabilitation are crucial, in order to optimise the surgical outcomes and ensure you make a speedy and full recovery. Here are some general guidelines:

Immobilisation:

Patients may need to wear a surgical boot or cast to protect the foot and promote healing. The length of time you will need to be in a boot will be determined by your surgeon, and will depend on the type of surgery that you have had.

Wound Care:

Proper wound care is essential to prevent infection. Keep the surgical site clean and dry, and follow any instructions provided by the surgeon. If you notice and unusual swelling or redness, or if the wound starts to weep and become very sore, or if you start to develop a temperature, you must contact your GP or surgeon straight away.

Weight Bearing:

Gradual weight-bearing may be allowed, initially with the aid of crutches or a walker. This will be directed by your surgeon and again, will depend on the type of surgery you’ve had..

Physiotherapy:

A structured physiotherapy program is absolutely vital in order to restore strength, flexibility, and range of movement, and regain full function and activity levels. At London Bridge Orthopaedics we have close working relationships with many outstanding Physiotherapists; your surgeon will put you in touch with someone who will ensure you are given the best possible care and rehab programme.

Activity Modification:

Avoid high-impact activities and wear supportive footwear to reduce stress on the foot during the recovery period. Comfortable trainers are often the best option initially, and you will likely need to avoid high heels!

Conclusion

Bunions can cause significant discomfort and impact quality of life, but effective treatment options are available. From conservative measures to surgical intervention, individuals with bunions have a range of options to alleviate pain and restore function. By understanding the anatomy, causes, symptoms, and treatment options for bunions, patients can make informed decisions about their care and work towards optimal recovery with the guidance of healthcare professionals.

London Bridge Orthopaedics

At London Bridge Orthopaedics we have three exceptional Foot and Ankle Surgeons, who all perform corrective bunion surgery. They will ensure that you receive the best possible care and will talk you through all the options that are available, before deciding on the right course of action for your individual needs.

If you would like to book an appointment, please call our booking line on 0203 576 5296 or use our online Booking Form. If you need to book a follow up appointment with your consultant, please call their individual secretary (details can be found on their profile page)

We are covered by all of the usual insurance companies, and we also see self pay patients.

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