HALLUX VALGUS (BUNION DEFORMITY)
A bunion, also referred to as a hallux valgus deformity, refers to a malalignment of the forefoot in which there is a prominence over the inner aspect of the foot near the great toe. This enlargement is generally caused by medial deviation of the metatarsal bone and lateral deviation of the great toe. This is a common and disabling deformity in which the patient can experience pain especially when wearing shoes. It may limit walking activities and sports participation. Occasionally, intermittent numbness or chronic thickening of the skin in the area at the prominence is experienced. The reason for bunion development is incompletely understood but often times grandparents, parents, and children may have hereditary bunions that run in the family. Another important factor in the development of a bunion deformity is poor choice of footwear, and specifically high-heeled pointed-toe shoes. Nearly 90% of the bunion operations are performed on females, which is likely secondary to footwear selection. If you must wear fashionable shoes, then consider selecting a style with a lower heel and a more rounded toe-box.
The goal of bunion treatment is pain relief and deformity correction. In early bunion treatment, the use of soft shoes with a large toe-box or leather stretchers to soften your shoes may be beneficial. Anti-inflammatory medications and pads to minimize pressure over the bunion may be helpful. A bunion splint at night may be helpful to slow progression of the deformity. As the bunion becomes more bothersome, operative intervention may be beneficial to correct the malalignment. There are many different types of surgical repairs designed for different types of bunion deformities. We will be happy to discuss in detail which type of bunion operation we would recommend for you based on your X-rays. The operative correction of a bunion deformity usually includes the placement of internal implants such as small plates or screws. The internal fixation generally does not cause a problem and can be left in place permanently or eventually removed.
Following surgery, careful postoperative care is needed in order to keep the foot in proper alignment while healing occurs. Usually patients do not need to spend the night in the hospital after a bunion surgery. Frequent office visits are necessary to inspect the incisions and to splint the toe in the correct position. You will likely be able to bear weight on your heel the first week after surgery. Although we will allow you to put weight on your heel, to help insure a good outcome, we will ask you to walk flat-footed for about 6 weeks without putting pressure on your toe. A postoperative boot with toe taping will offer protection for 6-8 weeks. Transitioning back into a regular shoe usually occurs around 8 weeks after surgery and activities such as jogging usually can be done safely around 12 weeks. Time off from work depends on occupation, but at least 1 week off may be necessary as elevation of the foot is very important for the first few days.