Bunions / hallux valgus

“Bunion” is a term used to describe a swelling at the base of the great toe. In most cases bunions are not caused by growth of extra bone but by the first metatarsal bone drifting out of alignment so that it becomes abnormally prominent in the medial (inner) side of the foot. To compensate the great toe drifts towards the lateral (outer) side of the foot. Over time the great toe may start to cross over or under the second toe, which may hammer. The foot becomes wider which can make it difficult to obtain comfortable footwear. As the great toe joint is no longer correctly aligned it often develops arthritis.

Treatment for hallux valgus can take many forms. Obtaining more roomy footwear may relieve pressure while orthotics (insoles) may re-balance the loading of the forefoot. These measures do not cure the deformity but may make it possible to live with. The only way to correct bunions is by surgery. Old-fashioned operations such as bunionectomy have been superseded by highly effective modern techniques such as the scarf osteotomy. These techniques aim to preserve the bones and joints while restoring the alignment of the great toe and first metatarsal. In most cases it is possible to bear weight on the foot from the beginning and so plaster casts and crutches are not usually required.