Minimally Invasive (Key Hole) Surgery for Bunions (Hallux Valgus)
A Typical Hallux Valgus (‘Bunion’) Deformity (patient’s right foot)
What Are Bunions?
A bunion is the lay term for hallux valgus, or deviation of the great toe. The deformity is complex and involves the big toe long bone (metatarsal) to deviate away (inward) from the second toe and the big toe itself to deviate outward, toward the second toe. Due to this movement, a prominence on the inside of the foot (the ‘bunion’) occurs and can cause symptoms. Contrary to popular belief, it is not a new growth of bone.
What Causes Them? There are a number of causes including genetics, foot wear (high heels, narrow toe box), family history and inflammatory joint disorders (eg rheumatoid arthritis). Other causes have been implicated such as flat feet and lax ligaments.
What Are The Symptoms? Most commonly pain around the bunion when wearing closed foot wear and a deformity that may get worse over time. Pain may also be experienced under the balls of the toes (metatarsalgia) or in the big toe joint. Normally wearing sandals or no shoes, relieves symptoms. Some patients with bunions have no symptoms at all.
Will It Get Worse? Progression of the deformity usually occurs, but over what time period is difficult to predict. This can take years.
What Is The Treatment? If you have no discomfort or pain, then you do not need to do anything. If you have symptoms, there are a number of non surgical options you should try, before considering surgery:
Bunion Pads (left and right), Silicon Toe Spacer (middle)
MIS for severe bunion. X Ray Before (left) and After (right) Minimally Invasive Bunion Surgery
Modify or change your foot wear The most important thing to do. A soft, wider shoe, with a small heel, which accommodates the foot well. Using a shoe stretcher, your current shoes may be made to fit.
Bunion Pads Often made from silicon rubber, these protect the prominent area from rubbing.
Silicon Spacers These can prevent toes rubbing if placed between the first and second toes.
Surgery If non surgical options fail to resolve symptoms, then surgery can be considered. What Does Surgery Involve?
This will depend on the nature of the deformity you have. Mild, moderate and sometimes severe deformities can be corrected by an operation which involves releasing the tight tissues, cutting the big toe long bone (metatarsal osteotomy), and shifting it back to its original position.
Sometimes very severe deformities or those with arthritis are better served with a fusion of the big toe joint or a joint implant. The operation can be performed as a Day Case procedure, under a local anesthetic ankle block, making the whole foot numb for 6-12 hours. You can be awake, sedated or have a general anesthetic during surgery, which takes about 45 minutes. Most patients do not experience significant pain after surgery with the modern techniques Dr. Fellner uses.
What is Minimally Invasive (Keyhole) Surgery?
This is the standard technique Dr. Fellner uses and most patients are suitable. The bunion correction is performed through small incisions. This is in contrast to traditional surgery, performed through large cuts on the foot.
As smaller incisions are made, much less soft tissue stripping is required to gain access to the bone in order to make the bony corrections. This may lead to:
Less joint stiffness (see video below)
Less internal scarring
Less damage to tissues
Minimal external scarring (no stitches needed)
Day case surgery
Quicker recovery time
Faster return to work and normal activities
Reduced surgical time
Possibly a better result
Click the link below to find out what to expect after your surgery:
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