Bunion Surgery London | Specialist Bunion Operation | Toe Straightening
A Bunion is a prominent bone on the knuckle (joint) of your big toe. It can become inflamed and painful. Bunion surgery involves realigning the bone that is sticking out and setting the toe joint into a better position. You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.
About bunion surgery
Bunions or hallux valgus ('hallux' means the big toe and 'valgus' means abnormal bending towards the other toes) are more common in women and run in families. A bunion can cause discomfort, pain, swelling and redness in and around the big toe. If left untreated, it can make wearing shoes painful. Surgery is used to correct the abnormal bending of your big toe, and to reduce pain and pressure.
Preparing for bunion surgery
Your surgeon will explain how to prepare for your operation. For example, if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection and slows your recovery.
Bunion surgery is usually done as a day-case operation, this means you will go home the same day.
You will usually be under general anaesthesia during the procedure so you will be asleep. Alternatively, you may have the surgery under local anaesthesia. This completely blocks the pain in your foot and you will stay awake during the operation. You may have a sedative with the local anaesthetic to help you relax.
If you are having a general anaesthetic, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours beforehand. However, some anaesthetists (doctors specialising in pain management and giving anaesthetic medicines for surgical procedures) allow occasional sips of water until two hours before a general anaesthetic.
Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.
You may be asked to wear a compression stocking on the unaffected leg to help maintain circulation.
What happens during bunion surgery
Surgery to remove a bunion usually takes less than an hour, but the time can vary.
Your surgeon will make a cut on the inner side of your foot, over your big toe joint.
The exact procedure you have depends on the type and size of your bunion. Usually your surgeon will remove some bone and may reposition bones, ligaments and tendons in your foot. Screws or wires may be used to keep the bones in place..
What to expect afterwards
You will need to rest until the effects of the general anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
Your foot will usually be heavily bandaged after the operation or you may have a plaster cast. This is to protect your foot and help keep it correctly aligned. You will usually have crutches and a special shoe to wear.
A physiotherapist (a health professional who specialises in movement and mobility) may visit you after your operation and give you some advice about how to move around safely. If needed, your physiotherapist may arrange a further appointment to help your recovery.
You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.
You will usually be able to go home when you feel ready..
Recovering from bunion surgery
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with the medicine and if you have any questions, ask your GP or pharmacist for advice.
General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drink alcohol, operate machinery or sign legal documents for 48 hours afterwards.
If you are in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon's advice. You won't be able to drive while your foot is in the post-operative shoe.
It usually takes four to eight weeks for the bones in your foot to heal. You will usually be able to walk immediately afterwards wearing the post-operative shoe, but may need crutches for the first few weeks. You will normally be required to wear the shoe for approximately six weeks. Keep the dressing or cast dry and always wear your protective over-shoe when you are outside. Also, resting with your foot up on a stool can help to reduce any swelling.
Your surgeon will give you advice about when you can go back to work, as this will depend on the type of operation you have had, and what stresses or pressures your feet will be under (eg walking around or standing).
What are the risks?
Bunion removal is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
These are the unwanted, but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic.
Your foot, especially your toe, will feel sore and have some swelling. This pain will gradually improve but it may take up to a year for the swelling to settle fully.
This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Complications specific to bunion removal are uncommon but can include:
-toe stiffness - the tendons in your big toe may be damaged, affecting how well your toe moves
-toe numbness - the nerves in the toe may be injured
-abnormal toe position - your big toe may heal out of line, bending outwards or upwards or be slightly shorter
-slow healing - this can cause ongoing pain and swelling
-wound infection - you may need antibiotics to treat an infection
-re-occurrence - the bunion may come back
The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.