Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

What is a Bunion ?What is a Bunion ? A bunion is a deformity of the forefoot which to A bunion is a deformity of the forefoot which to

the suffer appears to be a enlargement of the the suffer appears to be a enlargement of the big toe joint.big toe joint.

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

What are the symptoms/concerns ?What are the symptoms/concerns ? Pain Pain

At the site of the bunion At the site of the bunion At other areas of the foot At other areas of the foot At areas away from the foot e.g. postural At areas away from the foot e.g. postural

Reduced function and mobilityReduced function and mobility Footwear problems.Footwear problems. Concern that deformity will worsen in time Concern that deformity will worsen in time

and impact mobilityand impact mobility Cosmetic appearanceCosmetic appearance

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

What are the treatment options ?What are the treatment options ?

Tolerate.Tolerate.

Accommodate.Accommodate.

Operate.Operate.

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

Accommodate Accommodate

FootwearFootwear

Protective shieldsProtective shields

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

Operate Operate

There are over 100 hundred different There are over 100 hundred different operations described to correct bunions. operations described to correct bunions. This fact if nothing else demonstrates that This fact if nothing else demonstrates that there is no one fix for all.there is no one fix for all.

Current thinking favours tailoring the Current thinking favours tailoring the operation to the individual requirements.operation to the individual requirements.

Broadly speaking there are three options if Broadly speaking there are three options if surgery is required.surgery is required.

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

For small bunions or bunions where For small bunions or bunions where pressure from shoes is the main symptom pressure from shoes is the main symptom a bunion shave or bunionectomy may be a bunion shave or bunionectomy may be appropriate.appropriate.

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

For medium or large bunions where a For medium or large bunions where a shave alone is unlikely to offer lasting shave alone is unlikely to offer lasting benefit then a midshaft osteotomy is benefit then a midshaft osteotomy is usually performed.usually performed.

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

For severe bunions it is sometimes For severe bunions it is sometimes necessary to come further back into the necessary to come further back into the foot to correct the deformity. Usually this foot to correct the deformity. Usually this involves fusion one or more of the joints in involves fusion one or more of the joints in the midfoot or arch of the foot.the midfoot or arch of the foot.

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

RehabilitionRehabilition In the vast majority of cases we ask In the vast majority of cases we ask

patients to return to a roomy shoe such as patients to return to a roomy shoe such as a trainer after the 2a trainer after the 2ndnd redressing at around redressing at around 2 weeks.2 weeks.

Audit suggests that the majority of people Audit suggests that the majority of people can retrun to their normal footwear by 8 can retrun to their normal footwear by 8 weeks post-operativelyweeks post-operatively

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

RisksRisks Any surgery carries the risk of a complications which can Any surgery carries the risk of a complications which can

either delay recovery or render you permanently worse. either delay recovery or render you permanently worse. Such risks include:- Such risks include:-

Failure of operationFailure of operation Recurrence of deformity Recurrence of deformity InfectionInfection Deep vein thrombosisDeep vein thrombosis Ongoing pain and swelling at the operation site.Ongoing pain and swelling at the operation site.

Not having this surgery may also constitute risk e.g.Not having this surgery may also constitute risk e.g. Missed window of opportunity to have surgery.Missed window of opportunity to have surgery. Progression of deformity and effect on other parts of the foot.Progression of deformity and effect on other parts of the foot. Altered gait patterns resulting in muscular skeletal and postural Altered gait patterns resulting in muscular skeletal and postural

symptomssymptoms

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

Should I have surgery?Should I have surgery?

Ultimately whether or not you undergo Ultimately whether or not you undergo surgery is your decision.surgery is your decision.

In order to make the decision you should In order to make the decision you should take the time consider the take the time consider the benefits of the surgery benefits of the surgery the risks and rehabilitation the risks and rehabilitation the risks of not having surgerythe risks of not having surgery

Mr S Finney Consultant Podiatric SurgeonMr S Finney Consultant Podiatric Surgeon

Before and 2 weeks afterBefore and 2 weeks after