Bunion surgery

​A bunion is a bony hump at the base of the big toe.

I have a question about bunion surgery

What is a bunion?

A bunion is a bony hump at the base of the big toe. Hallux rigidus refers to a stiff big toe caused by degenerative arthritis or a bone spur that affects the joint at the base of the big toe.

What causes a bunion?

The underlying cause of a bunion is a joint deformity of the base of the big toe but it is not always clear why this deformity occurs in the first place. Possible reasons include:

  • a genetic tendency to a joint weakness/flat feet
  • osteoarthritis or rheumatoid arthritis
  • gout
  • other conditions such as cerebral palsy and Marfan syndrome
  • wearing badly fitting shoes

What is bunion surgery or Scarf/Akin osteotomy?

Osteotomy or Bunion surgery is carried out to correct a deformity at the base of the big toe. It may involve removing parts of bones and realigning them to straighten the toe.

Why would I have bunion surgery?

A scarf osteotomy (sometimes performed with an Akin osteotomy) is surgery for bunion removal or the correction of a deformity at the base of the big toe, and the realignment of the toe itself.

During the procedure parts of bone are removed and the bones of the foot and toe are realigned correctly. Any bunions, or bumps on the joint, will be removed at the same time. The procedure will help correct the deformity, alleviate the pain associated with the condition and reduce the pressure caused by the big toe jamming against the other toes.

What happens during bunion surgery?

The operation may be carried out under a general anaesthetic (so you’ll be asleep) or a local anaesthetic (so you’ll stay awake but won’t feel anything). The operation usually takes around an hour and you’ll usually go home on the same day.

There are a number of different types of operation used to treat bunions; the type of surgery you undergo will be discussed with your specialist beforehand. It will depend on the exact condition you have, its severity, the shape of your foot and whether you have any wear and tear (osteoarthritis) in the joint.

One common procedure is called a scarf osteotomy (an osteotomy means a cut in the bone) where the bone is cut and rejoined to improve the alignment of the toe. The operation is carried out through one cut on the foot, to the side of the big toe. A tendon is adjusted to bring the toe into the correct position before the bone is cut and realigned. The bone is then fixed with screws and the joint is repaired to keep the toe straight.

 In some severe cases, an additional procedure called an Akin osteotomy may be needed to achieve good correction and alignment.

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