How is the Surgery Performed?

The operation you have depends on how severe your bunion deformity is. A cut is required on the inner edge of the foot. All operations involve changing the alignment of the bones, and very little bone is actually cut off. The bone is carefully divided and one part is shifted sideways. The new position is held with special screws.

Mild to moderate bunions can be treated by cutting the bone in an arrowhead shape (chevron). Moderate to severe bunions require a Z shaped cut (so called ‘scarf’ cut) in the bone that allows rotation as well as sideways movement. Very severe deformities may require a crescent shaped cut (basal dome) at the base of the bone or fusion of one of the joints half way up the foot.

A tendon that attaches to the outer side of the big toe can cause recurrence, and this must be cut. This often requires an extra cut in the web space between the big and second toes.

Often, surgery is required for hammer toes or metatarsalgia if this exists, and it will be performed at the same time.

Surgery is carried out under general anaesthetic, but can be carried out with local anaesthetic injections behind the knee or around the ankle. The injections are normally given while you are asleep for your comfort. They can give good pain relief for the first day after the operation. You can go home the same day in the evening.

Risks of Surgery

Bleeding, infection, poor bone healing, poor skin healing, injury to tendons, injury to nerves, recurrence, and a need for further surgery.

There is a small risk of blood clots in the legs or lungs (DVT and PE), and there are also risks from anaesthesia - the process of being put to sleep for your operation.

Risks of Anaesthesia

The injection behind your knee is given using an ultrasound machine to guide the needle. There is a less than 1% chance of injury to the nerve. General anaesthetic also carries risks. These risks are proportional to your general health. You will need to be assessed for your fitness for surgery and an Anaesthetist will be able to advise you on your individual risk.

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left foot pre op

right foot 2 weeks post op

left foot 2 weeks post op

right foot 3 months post op