A bunion (hallux valgus) is a deformity of the foot that changes the shape of the foot due to angulation of the big toe towards the second toe. It is not usually caused by a growth of bone but often the angulation results in a swelling on the inside of the foot that rubs on shoes, causing inflammation and pain. Bunions often run in the family and are due to anatomical and mechanical factors that change the alignment of the toes. Joint damage and inappropriate footwear can also lead to bunions.
Conservative treatment of bunions consists mainly of better shoe selection, the use of insoles or pads and stretching exercises. Splints are not usually effective. Surgical treatment usually involves a realignment of the forefoot bones to straighten them out.
When surgery is recommended a number of different procedures are now available and the surgeon will suggest the most appropriate one for each case. The tight tendon pulling the big toe inwards is released and some bone shaved off the bunion bump. Realignment is achieved by cutting and redirecting the first metatarsal bone (osteotomy) or fusing the joint at the base of the deformity (Lapidus procedure). Screws are used to hold the bones in place while they heal. After surgery you may be in a cast or splint for some weeks depending on the procedure. Recovery following bunion surgery takes weeks or months before full activities can be resumed.
Complications from bunion surgery are uncommon but may include infection, toe stiffness, loss of correction, overcorrection and nerve problems.