Common name
Who does it affect?
Bunions tend to run in families, but that does not
mean that if you have a bunion your children will have one too. More
common in females and more common in the over fifties.
Symptoms
Pain over the bony prominence, usually from
pressure of the shoe. Sometimes the skin over the lump becomes red and
infected. Often the big toe can rub on the second toe, pushing it up and
out of joint, causing pain under the ball of the foot.
Investigations
X-ray of the foot is required to illustrate the
magnitude of the deformity and any associated arthritis.
Non-operative treatment
Painkillers (analgesia) and accommodative shoewear
(wide fitting, deep toebox, soft leather uppers). Occasionally insoles
can help.
Operative treatment
If the above non-surgical measures are unhelpful,
surgery is performed under general anaesthesia or regional anaesthesia
(only the foot is numb). A tourniquet is used, which is like a blood
pressure cuff around the upper thigh which prevents blood from obscuring
the surgeon’s view. There are a few different operations for bunions
depending upon the severity of the deformity and whether any associated
arthritis has developed in the big toe joint. Most involve cutting and
realigning the bones in the forefoot to narrow the forefoot, excise the
bony prominence and straighten the big toe. If additional surgery is
required to the second toe then often a K wire is used temporarily (for
a period of four weeks) to hold the position whilst the wounds heal.
Skin is sutured and a plaster slab is sometimes used depending on
surgeon preference. Patients would be allowed to fully weight bear
post-operatively. |
