Bunion (Hallux Valgus)

What are bunions (hallux vagus)?

A bunion (hallux vagus) is a common and potentially painful condition with unclear causes, which appears to be a deformed bony bump on the joint at the base of your big toe. It happens when your big toe point towards your second toe. Hallux means big toe and valgus means bent out or twisted out.

What are the symptoms of bunions (hallux vagus)?

• A bulging bump on the outside of the base of your big toe
• Swelling, redness or soreness around your big toe joint
• Corns or calluses — these often develop where the first and second toes overlap
• Persistent or intermittent pain
• Restricted movement of your big toe if arthritis affects the toe

How are bunions (hallux vagus) prevented?

• Choose shoes carefully. They should have a wide toe box — no pointy toes — and there should be space between the tip of your longest toe and the end of the shoe.
• Your shoes should conform to the shape of your feet without squeezing or pressing any part of your foot.
  

What are the risk factors for bunions (hallux vagus)?

These factors might increase your risk of bunions:

• High heels

  • Wearing high heels forces your toes into the front of your shoes, often crowding your toes.

• Poor fitting shoes

  • People who wear shoes that are too tight, too narrow or too pointed are more susceptible to bunions.

• Heredity

  • The tendency to develop bunions might be because of an inherited structural foot defect.

• Rheumatoid arthritis

  • Having this inflammatory condition can make you more susceptible to bunions

How are bunions (hallux vagus) diagnosed?

​Generally, observation is enough to diagnose a bunion, as the bump is obvious on the side of the foot or base of the big toe. However, your surgeon may order X-rays that will show the extent of the deformity of the foot.

How are bunions (hallux vagus) treated?

​If you have severe pain or trouble walking, and the symptoms do not improve with conservative management, your doctor may recommend bunion surgery. There are different types of surgeries to correct a bunion. Bringing the big toe back to its correct position may involve realigning bone, ligaments, tendons, and nerves.

How do you prepare for bunion (hallux vagus) surgery?

Fasting instructions

Fasting is essential prior to bunion surgery. In the event you did not follow the instructions, the bunion surgery will be rescheduled. No food or drinks (except plain water) after midnight or as instructed. Last drink allowed is half a cup (100ml) of plain water.

Medications

Certain medications need to be stopped in preparation for the bunion surgery. Please inform your doctor of all medications you are on, especially blood thinners or herbal medications.

Special instructions

• Any recent infection, be it involving the throat, lung, urinary tract or skin must be highlighted to the surgeon prior to bunion surgery. Your surgery might have to be postponed.
• Have a parent / legal guardian to give consent if you are below 21 years old.
  

What can you expect after bunion (hallux vagus) surgery?

Activity

You will be supplied with a wedge shoe after bunion surgery - you are to wear it at all times when you walk so that your full body weight will be on your heel. Some bunion procedures allow you to walk on your foot right after the bunion surgery. In these cases, patients must use a special surgical shoe to protect the bunion correction.

Follow the instructions from the surgeon strictly to prevent the bones from shifting and the bunion correction failing.

Exercise

Specific exercises will help restore your foot's strength and range of motion after bunion surgery. Always start these exercises slowly and follow instructions from your doctor or physiotherapist regarding repetitions.

Wound care

• Your doctor will apply your dressing in a specific way to keep the bones in correct position.
• Keeping your toe in position is essential for successful healing.
• It is very important to follow your doctor's directions about dressing care.
• Do not change the dressing without consulting your doctor.
• Be sure to keep your wound and dressing dry.
• During shower , cover your foot with a plastic bag
• Referrals for change of dressing is not given to patient as you need to keep their dressing till follow up.
  

Special instructions

• Avoid strenuous movements such as twisting; and high impact activities such as jumping and running.
• Shoe Wear- It will take several months for your bones to be fully healed. When you have completed the initial rehabilitation period, your doctor will advise you on shoe wear.

How to elevate your foot after bunion surgery:

Keep your foot elevated as much as possible for the first few days after surgery, and apply ice as recommended by your doctor to relieve swelling and pain. Never apply ice directly on your skin. It is common to have some swelling in your foot from 6 months to a year after bunion surgery.