Hallux Valgus (Bunion)

Surgical correction of the deformity of the metatarsal bone (Hallux Valgus)

Hallux in Latin means a big toe and valgus – describes the direction of the deformity. A deformity of the first metatarsal bone and the big toe develops when the big toe deviates towards the other foot toes and the first metatarsal bone deviates towards the absolutely opposite direction.

The joint between the big toe and the first metatarsal bone is a complex joint. Human motions are associated with active involvement of bones, ligaments and tendons forming the joint. Together they are impacted by the body weight and its distribution. A long-term traumatisation of a joint results in bone deformities. This disease more often affects females who wear narrow high-heeled shoes, such shoes severely traumatise a foot, as it gets the load of a whole-body weight.

Elderly people also experience bunions as their big toe joint is commonly affected by arthritis. Often there is a family history of bunions. However, hereditary are not bunions but a foot type People with a wide foot or a low foot arch are more tend to develop bunions than those with a high foot arch. Arthritis of different types also help to develop bunions. Arthritis affects a protective cartilage and a joint, limiting its mobility. A tendency to develop the disease is hereditary, therefore parents should monitor their child for the development of early signs of foot deformity and child's discomfort. If child’s foot is of the same type as his/her parents it is likely that eventually he/she develops bunions. Disease symptoms are mainly concentrated around the bunions centre. They become painful, making difficulty walking with high-heel or even normal shoes. The skin and soft tissues around the bunions get swollen and inflammation develops.

A surgery is recommended only in cases when a conservative treatment fails or in case of progressing deformity. Bone deformity and pain after the surgery usually resolve in the majority of patients.

About the surgery:

The point of surgery is to correct the bone axis, to remove the bone outgrowths and to restore a normal joint function.

To whom this surgery is indicated?

A surgery is recommended only in cases when a conservative treatment fails or in case of progressing deformity. The feet are examined, and several important angles formed by the foot bones are measured in the X-ray images to determine the deformity degree and to choose the type of surgery.

Before the surgery:

The team of physicians in our clinic will carry out all necessary examinations and will assess general patients’ health condition. Aiming to ensure the best possible result, before the surgery you should follow physician's instructions.

During the surgery:

The surgery will be carried out under a general anaesthesia. Usually, the surgery lasts for about 1 to 2 hours.

• In case of mild hallux valgus deformity, the bone outgrowths are removed and plastics of tendons and ligaments adjacent to the joint  is carried out.
• Treatment of moderate  hallux valgus deformity involves removal of the bone outgrows, reposition of the dissected bone into its proper position and plastics of tendons and ligaments adjacent to the joint.
• In case of sever hallux valgus deformity bone outgrowths are removed, a wedge-shaped part of the bone is removed, the bone is repositioned into its proper position and fixed using the metal constructions as well plastics of tendons and ligaments is performed.
• If the joint is damaged severely, additional plastics of the soft tissues and endoprosthetic joint surgery can be applied.

After the surgery:

After the surgery the patient for several hours is transferred to an intensive care ward for observation, later the in-hospital treatment is continued. Usually on the next day after the surgery the patient is discharged. Dressings are applied on the feet for some3 to 6 weeks and subsequently special shoes are chosen. Later wearing of regular footwear is allowed, however physical activity is limited for more 8 to 12 weeks.

In cases of moderate and high severity the dissected bone is fixed applying metal stems, screws or a plate. A plater splint for 4 to 6 weeks is applied after the surgery in more severe cases. Walking with crutches and avoiding stepping on the affected leg is recommended. The bone healing takes some 8 weeks. Exercises for the big toe are very important during the post-surgical period. The exercises are initiated on Day10 to 12 after the surgery when the surgical wound has healed. Before leaving the hospital, the doctor will provide you with the  instructions regarding your further treatment.