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Bunion

Bunion

Do you have a bony, painful bump at the base of your big toe? Bunions can form at this joint and will not go away on their own. This doesn’t mean that your lifestyle has to be affected, we can help.

Bunion (Hallux abductovalgus)

What is a bunion?

A bunion is a ‘bump’ on the joint at the base of the big toe known as the first metatarsophalangeal joint (1st MPJ) – that occurs when the bone or tissue at the big toe joint moves out of place.

The visible bump actually reflects changes in the bony framework of the front part of the foot. A Bunion is a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which continues to become increasingly prominent. Usually, the symptoms of bunions appear at later stages, although some people never have symptoms. If left untreated, the big toe may affect the second toe to dislocate from the joint.

If you are in pain and suspect you have a bunion, an early diagnosis and treatment are recommended, as non-surgical and surgical treatments are available.

You may be a candidate for minimally invasive surgery for your bunion. Check out the Minimally Invasive Keyhole Foot Surgery (MIS) section under Procedures.

Causes

Genetics: If other members of your family have bunions you have a higher risk of developing a bunion, but it does not mean you will definitely develop one.

Biomechanics: Abnormal function of joints in your feet can predispose you to the development of bunion deformities.

Arthritis: Rheumatoid arthritis, gouty arthritis or psoriatic arthritis.

Other conditions or syndromes: Cerebral palsy and Marfan’s syndrome, when ligaments are genetically loose.

Poorly fitting shoes: Pointy or narrow shoes, or high-heeled shoes.

Treatment

Conservative

Wearing appropriate shoes: The use of shoes with a wide toe box and low heel can alleviate pain and pressure on the bunion.

Orthotics: Custom-made or over-the-counter shoe inserts can help to redistribute pressure away from the bunion.

Toe spacers or separators: These devices can help to straighten the toes and reduce pressure on the bunion.

Padding and taping: Soft padding can help to cushion the bunion, and taping can help to hold the toe in a more natural position.

Foot Exercise: Certain exercises, such as toe stretches and foot strengthening exercises, may help to reduce pain and improve flexibility.

The evidence supporting these conservative treatment options is varied, but some studies have suggested that they may be effective in reducing pain and improving function in individuals with bunions, although none of the conservative treatments fixes bunions.

Surgical

Surgical treatment for bunions is usually recommended when conservative treatments have failed to relieve symptoms and the bunion is causing significant pain or affecting daily activities.

There are around 130 different procedures for bunion surgery. The specific details of the procedure will depend on the severity of the bunion, the underlying cause, and the surgical technique used.

Dr Kim offers six different surgical techniques depending on what would warrant the best outcome.

  • MICA (Minimally Invasive Chevron + Akin)
  • Distal Chevron Osteotomy + Akin Osteotomy
  • Scarf + Akin Osteotomy
  • Proximal Chevron Osteotomy + Akin Osteotomy
  • Lapidus Bunionectomy + Akin Osteotomy
  • First metatarsophalangeal joint arthrodesis

Your doctor will decide what procedure is performed depending on your bunion, but it typically involves:

  • Removal of bunion
  • Releasing tight ligaments, capsule and tightening loose ligaments
  • Cutting and realigning first metatarsal bone with fixation (K-wire or screws)
  • Additional procedure may be warranted to correct the big toe

See our Facebook page for more Before & After Photos

Before & After Photos

Bunion 2-horz
Bunion 3
49 19.Bunion right
67 34.Bunion
63 32.Bunion
82 42.Bunion
Lapidus + Akin Osteotomy
55 25.Bunion
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Before & After Photos

15 5.Bunion
Bunion 6
71 37.Bunion
85 45.Bunion
38 16.Bunion
52 22.Bunion
68 35.Bunion left
86 46.Bunion
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Appointment Information

Cost & Item Codes – Our fees are quoted on a case-by-case basis after your initial consultation with the surgical podiatrist as each patient presents differently and each surgery varies from patient to patient. Please book an initial consultation to discuss this further.

Scans – We recommend you have weight bearing x-rays prior to your appointment.

Telehealth – We may be able to offer an initial telehealth appointment if you live a distance away. Phone one of our friendly staff to see if this is possible for you. We may ask you to email some photos prior to your appointment. (1. from patient looking down at the front of their foot/feet 2. if someone can take a photo at floor level from behind of foot/feet)

Surgery Information

Do I need surgery? – Although your doctor may recommend an operation for your bunion to improve the function of your foot and reduce pain, it is your decision if you go ahead with the operation or not. Bunion is often progressive and once the second toe overlies or underlies your first toe, additional operations are required to address the deformed lesser toes.

The operation can be done through keyhole incisions or a traditional open approach. This is usually discussed during your initial consultation.

Duration – The procedure typically takes between one and two hours to complete, and patients can usually return home the same day.

Anaesthesia – Bunion surgery can be performed under general anaesthesia, local anaesthesia, or regional anaesthesia, depending on the surgeon’s and the patient’s preferences.

Medications – Your doctor will discuss all medications with you on your initial consultation.

Smoking – If you are a smoker, you need to stop the habit of smoking 4 weeks before your operation for normal healing and reduce postoperative complications. Nicotine is known to stop bones from healing.

Recovery Process

Patients must follow their doctor’s instructions carefully during recovery to ensure proper healing and minimize the risk of complications. This may include avoiding certain activities or bearing weight on the operated foot for a certain period.

The recovery process following bunion surgery varies depending on the type of surgery performed and the individual patient. In general, the following timeline can be expected:

Immediately after surgery: Patients will likely experience pain, swelling, and discomfort in the operated foot. Pain medication will be prescribed to manage this discomfort.

The first few days: Patients must keep the foot elevated as much as possible to reduce swelling. Crutches or a walker may be required to get around.

1-2 weeks: Patients must wear a special postop shoe or boot to protect the foot and allow for proper healing. Depending on the type of surgery, the shoe or boot may need to be worn for up to six to eight weeks. Minimal weight bearing with foot/feet elevated, getting up for essential things only like toilet breaks 5-10 minutes maximum per hour.

2-4 weeks: You may be weight bearing as tolerated in your post-op shoe. Movement is limited out of the house and patients are expected to rest and elevate as much as possible even when they are advised they are able to walk.

4-6 weeks: Continue as directed. It can take six weeks or longer before swelling has gone down enough to wear normal soft shoes.

6-12 weeks: Patients will gradually increase their activity level and may begin physical therapy to restore strength and mobility to the foot. During this time, the patient may return to light exercises.

3-6 months: Patients will continue to follow a rehabilitation program, including exercises to improve range of motion and strength in the foot.

Rest – 1-2 weeks (minimal weight bearing for essential things only like bathroom breaks 5-10 minutes maximum per hour)

Walk – 4 weeks (movement limited outside of house)

Driving – 4-8 weeks

Return to sedentary work – 2-3 weeks (If you work at a desk with minimal time on your feet and you are able to elevate your foot/feet)

Return to active work – 6-8 weeks (If you have a physical job or are standing a lot and unable to elevate your foot/feet)

Low impact exercise – 8 weeks (slow walking, cycling, golf using a caddie)

High impact exercise – 12 weeks (fast walking, running, jumping, playing sport)

Some possible complications following bunion surgery include infection, bleeding, swelling, joint stiffness, nerve damage, or bunion recurrence. Patients should contact their surgeon if they experience any signs of complications, such as fever, redness, or increased pain in the affected foot.

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Surgery

When to consider surgery?

Bunion surgery may be recommended when conservative treatments, such as wearing wide and comfortable shoes, using orthotics, or taking pain medications, have not adequately relieved bunion symptoms. Surgery may also be recommended if the bunion is causing significant pain or difficulty with walking or if the deformity is severe and interfering with daily activities.

What Does the Evidence say about bunion surgery?

Bunion surgery is one of the most common orthopedic procedures of the feet that is performed to correct a deformity of the big toe joint. Surgery aims to reduce pain, improve function, and fix any underlying deformity. There is a considerable amount of evidence on the efficacy and safety of bunion surgery. The results suggest that the procedure can effectively reduce pain and improve function in most patients.

Several studies have reported high success rates for bunion surgery, with over 80% of patients experiencing significant improvement in pain and function following the procedure. However, the type of surgery performed, the severity of the bunion, and the individual patient’s health status can all influence the success rate of the surgery.

Is the bunion surgery safe?

In terms of safety, studies have reported low rates of serious complications associated with bunion surgery, such as infection, nerve damage, scarring, swelling, return of deformity. However, like any surgical procedure, there are always risks associated with anesthesia and the surgical process itself.

One of the critical factors in the success of bunion surgery is the proper selection of patients for the procedure. Patients who are good candidates for surgery tend to have a clear indication for the procedure, good overall health, and realistic expectations for the outcome of the surgery. Patients who are not good candidates for surgery may experience poor outcomes, such as persistent pain, swelling, or deformity.

In summary, bunion surgery is a safe and effective procedure for treating bunions in most patients. However, the success of the procedure depends on careful patient selection, proper surgical technique, and appropriate post-operative care. Patients considering bunion surgery should consult with Dr Kim to discuss the procedure’s benefits and risks and determine whether they are good candidates for surgery.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Specialist Surgical Podiatrist Dr Kim is the leading specialist for Foot Surgery in Brisbane and Gold Coast, contact him today to see if you are a good candidate for bunion or tailor’s bunion keyhole surgery

No referral needed

Contact Us

A GP referral is welcome however it is not essential for your appointment

About

Dr Ji Soo Kim (Specialist Surgical Podiatrist) BPodM, DClinPod, FFPM RCPS(Glasg)

Book Appointment

Dr Kim has two offices, one located in Kelvin Grove, Brisbane. The other is in Southport, Gold Coast.

Please call 1300 522 096

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