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Hallux Valgus Correction

What Is A First Toe Bunion?

A 1st toe bunion, or Hallux abducto valgus, is a common condition that effects the 1st toe (also known as the hallux, great toe, or big toe) and forefoot alignment of many Australians.12 It can occur at all stages of life. Often people experience pain and discomfort with a bump developing on the inside of their foot at the base of their big toe. The 1st toe may also migrate toward the 2nd toe and even rub or cause the 2nd toe to shift upwards and also become painful (see Hammer toe surgery)

 

The bump is caused by a change in the alignment of bones in the toe and at the 1st Metatarsal phalangeal joint, the large joint at the base of the 1st toe.

 

Treatment should be considered if you are experiencing discomfort in everyday shoes, a loss of function or restriction in activities, or you have regular pain.

How Are First Toe Bunions Treated?

Bunions can be treated conservatively or with surgical correction. It is important to consider conservative treatment before pursuing surgical options.

 

Dr Pocklington is both a Podiatric Surgeon (foot and ankle specialist surgeon) and trained podiatrist with extensive understanding of the form and function of the foot before and after surgery. This includes consideration of conservative as well as surgical intervention and the overall function (biomechanics of your foot).

 

Conservative care for a bunion includes accommodation and support with shoe modification, intrinsic muscles strengthening, as well as taping and strapping and more.3 While a bunion cannot be corrected via conservative measures, comfort and function can be maximised without the need for surgical intervention. Dr Pocklington can fully assess your toe and feet to determine which treatment is best for you.

When Should I Consider 1st Toe Bunion Surgery?

If conservative measures are not able to alleviate your discomfort or the deviation of your first toe is significant then 1st toe bunion surgery should be considered. The goal of surgery is to restore the normal shape and function of the 1st toe and foot.

 

The key result is reduction or resolution of pain and a healthy return to normal activities. As a Podiatric Surgeon, Dr Pocklington is a foot and ankle specialist trained extensively in procedures used to treat 1st toe bunions and can assist you in deciding whether surgery is right for you.

What Will My Surgery Involve?

Bunion correction can be performed with several different approaches and procedures. Determining the correct procedure involves a thorough examination of your foot and medical history. Generally, surgery will be performed at the head, middle or base of the 1st metatarsal, the proximal phalanx, or the metatarsal-cuneiform joint.

 

The surgery will involve an incision and surgical fracture (cut) to one or more bones in your foot, allowing the bones to be manipulated and realigned. The cuts are then fixated with screws or other fixation devices including surgical plates or wire.

 

Each procedure is appropriate for certain presentations and severity of condition. Similarly, each has advantages and risks that Dr Pocklington will discuss with you in detail prior to your surgery. Most procedures take between 20 minutes and an hour to perform. Anaesthetic injections are used to numb your foot locally in all cases, but an anaesthetist will also provide either a general anaesthetic or IV sedation.

Care and Recovery After Surgery

Usually bunion surgery is a day procedure allowing you to immediately weight bear on your foot in a stiff sole surgical shoe. Sometimes people stay overnight at a private hospital and return home the following day.

 

Pain relief after surgery usually involves a combination of painkillers and anti-inflammatories, but significant pain relief is often unnecessary. Paracetamol is usually all that is required within the first week.

 

Bony healing usually occurs 6 to 8 weeks after the surgery and during this time restricted activities, including time off work is recommended. Dressings are removed and replaced at 1 week, giving you an opportunity to see your progress and discuss it with Dr Pocklington. At 2 weeks sutures are usually removed. The process of healing after surgery is important and requires ongoing attention from your surgeon. A podiatric range of motion exercise and stretching rehabilitation program begins immediately to ensure function is returned to the foot, toe and your life as soon as possible.

 

Please book online to speak with Dr Pocklington about bunion correction.

  1. Bennett PJ. Prevalence and type of foot surgery performed in Australia: A clinical review. The Foot. 2007 Dec 1;17(4):197-204.
  2. Gilheany MF, Landorf KB, Robinson P. Hallux valgus and hallux rigidus: a comparison of impact on health-related quality of life in patients presenting to foot surgeons in Australia. Journal of foot and ankle research. 2008 Dec 1;1(1):14.
  3. Hurn SE, Vicenzino BT, Smith MD. Non-surgical treatment of hallux valgus: a current practice survey of Australian podiatrists. Journal of foot and ankle research. 2016 Dec 1;9(1):16.

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