(hallux valgus)
A bunion is a prominence on the inside of the big toe. This is associated with a big toe that has deviated outwards.
Hallux valgus may cause no problems at all. However it may cause pain, difficulty with shoewear and problems with the smaller toes.
Symptoms of hallux valgus may be treated with or without surgery.
Non-operative treatments involve alterations in shoewear and local supports. These will aim to relieve the discomfort but will not correct the condition or improve the appearance.
Corrective surgery involves excision of the prominence on the inside of the foot (bunionectomy). This needs to be combined with a bone cut (osteotomy) of one or more bones of the big toe to straighten the toe. Soft tissues also need to be addressed.
There are many ways to correct a hallux valgus. A ‘scarf osteotomy’ of the 1st metatarsal is commonly used, often combined with an ‘Akin osteotomy’ of the proximal phalanx. The bone cuts are held with screws and staples to prevent loss of position.
In patients with arthritis associated with a bunion, or a very large deformity then a fusion of the big toe may be more appropriate.