BUNION SURGERY (INCLUDING TAILOR'S BUNION)

What is bunion surgery?

Scarf osteotomy and chevron osteotomy are two of the most well-known types of bunion surgery. They are usually day case procedures carried out under a general anaesthetic. An additional pain-relieving local anaesthetic is administered to the foot post-operatively. Tailor’s bunion surgery can be offered for this particular type of bunion, which occurs at the bottom of the little toe joint.

What does bunion surgery involve?

An incision is made along the big toe. The bones are then separated and re-sited, being fixed in position by tiny screws.

Why might I need bunion surgery?

If you are suffering with a bunion or hallux valgus, a bony lump that appears at the bottom of the big toe, causing the toe to bend inwards, you may need bunion surgery. Symptoms include:

• On the outer edge of your foot, a bony lump will form, which may rub against your shoe, creating swelling and pain
• At the point where the big toe and second toe overlap, there will be inflamed, hard skin
• The metatarsal bones (bones in the ball of foot) may start to protrude
• Hammer toes – deformation in the small toe joints
• Left untreated, the symptoms can deteriorate and cause greater deformation of the foot. On occasion, the big toe will force itself beneath the second toe, which may lead to big toe arthritis

How long does it take to recover?

Immediately following your operation, your physiotherapist will show you how to use your crutches and will talk you through your tailored exercises to help your recovery. You will also be given a padded stiff shoe to support your toe. This shoe allows you to put weight on your heel, whilst protecting the part of your foot that has been operated on.

Over the first two weeks after your surgery, you should try to rest your foot as much as you can. By the end of the first week, your foot will be significantly less painful, and during the second week you can begin to walk short distances at home using your surgical sandal. To aid your recovery, you should try to wriggle your toes as much as possible during this time.

After two to three weeks, you’ll be given your toe alignment splint, which must be worn for a further three to four weeks (six weeks after your surgery). It is also important to do your toe bending exercises – these will aid your recovery by reducing the development of painful scars and the stiffness of the toe joint. If surgery was on your left foot, you can usually start driving if you drive an automatic car at this point, if advised by your consultant. However, you should also check with your car insurance provider.

You will be able to walk short distances after between four and six weeks and can return to normal, flat shoes. It is important to remember that your foot will still be swollen at this stage. You can return to low impact sports after around six weeks, and will be able to move your foot normally. It is important, however, not to overdo it, so try to avoid walking long distances. You should also be able to start driving a manual car, if advised by your consultant, but also check with your car insurance company.

As your foot continues to heal, you will be able to resume higher impact sports. After twelve weeks, patients are walking normally, can take part in high impact exercise and can wear high-heeled shoes.

What is the long-term impact of bunion surgery?

Between three to six months post-surgery you will normally have a final review with your consultant. Some swelling may remain at this point, but a year after your operation healing should be complete and any remaining swelling will have disappeared. Patients should be able to return to their normal lifestyle.

Tailor’s bunion surgery

This procedure is performed for the treatment of deformity and pain caused by Tailor’s bunion, a little lump protruding from the joint at the bottom of the little toe.

What does Tailor’s bunion surgery involve?

Surgery is normally a day case procedure, performed under a general anaesthetic, with a post-operative local anaesthetic administered in the foot to minimise pain. A small incision is made above the bony lump, which is then cut away with the bones realigned and fixed in position by a miniscule screw.

Why might I need Tailor’s bunion surgery?

You may need Tailor’s bunion surgery if you have a lump that appears at the base of the little toe, on the fifth metatarsal bone, known as a Tailor’s bunion, or bunionette. It’s similar to a bunion on the big toe but occurs less frequently. It is caused by the dislocation of the joint at the base of the little toe, which causes the lump to appear. Pain, inflammation and swelling around the joint indicate a Tailor’s bunion.

How long does it take to recover?

Immediately following your operation, your physiotherapist will show you how to use your crutches and will talk you through your tailored exercises to help your recovery. You will also be given a hospital shoe.

Over the first two weeks after your surgery, you should try to rest your foot as much as you can. By the end of the first week, your foot will be significantly less painful. You can begin to walk short distances at home using your hospital shoe.

After two weeks your bandages will be removed and the foot will be examined. At around six weeks after surgery you will be able to fully weight bear in your own shoes.

if your job involves sitting down for most of the time, you should be able to return to work after two weeks; if it involves manual work, you may need to have up to eight weeks off.

You should also be able to start driving within four to six weeks, but also check with your car insurance company.

What is the long-term impact of Tailor’s bunion surgery?

Between three to six months post-surgery you will normally have a final review with your consultant. Some swelling may remain at this point, but a year after your operation healing should be complete and any remaining swelling will have disappeared. Patients should be able to return to their normal lifestyle.