Bunions or hallux valgus are an extremely common condition. Typically, the big toe will deviate towards the lesser toes and a prominence over the inner side of the big toe develops. As the deformity progresses, the forefoot (front part of the foot) gets broader. This broadening combined with the protruding bunion makes shoewear painful and causes pain and redness over the bunion.

Over time, as the big toe starts to encroach into the territory of the 2nd and 3rd toes, these toes can start developing hammer toe and claw toe deformities. This can result in pain over the top of the 2nd and 3rd toe, or in some cases overload and a painful callosity over the sole underneath the 2nd or 3rd toes. See media article on ‘unhappy feet’.

Managing bunions through surgery and other methods

Mild symptoms from a bunion typically can be managed with shoewear with a broad toe box to prevent pressure over the forefoot. Physiotherapy can also be used to stretch out a tight calf (gastrocnemius) muscle in an attempt to reduce pressure on the forefoot. When simple measures fail, corrective surgery for the bunion and in some cases the 2nd and 3rd toes can give a long-lasting correction and relief from pain.

The changing nature of surgery

In the past, bunion surgery typically would require a period of non-weight bearing and a prolonged rehabilitation period with a foot cast. Protruding wires would also be used before.

There have been significant advances in bunion surgery since. Currently our clinic performs bunion surgery as a day surgery and involves the use of internal fixation that avoids protruding wires. The correction is also very stable and patients are able to immediately walk on the foot with a medical sandal. Typically, an anaesthetic block is also given during surgery so that the pain after the surgery is minimized and usually very tolerable.

To learn more about this condition and our capabilities to assist, speak to our practice at 6734 8168 or send an email to email@footandankledoctor.com.sg.

A less severe bunion
More severe bunion, the other toes are also deformed. Both deformities can be effectively corrected.
A typical postoperative Xray after a bunion correction with the Scarf osteotomy. Osteotomies are used to translate the bone for correction and are fixed with mini-screws that give a stable and reliable result.