Bunions (Hallux Valgus)Bunions can occur in adolescence or develop as you get older. The deformity...
Transcript of Bunions (Hallux Valgus)Bunions can occur in adolescence or develop as you get older. The deformity...
Bunions(HalluxValgus)Bunionsareacommonfootdeformityofthebigtoe.Theyareoftenaninheritedcondition.Footweardoesnotdirectlycausebunionsbutmaycontribute.Bunionscanoccurinadolescenceordevelopasyougetolder.Thedeformityofabuniontendstoworsenovertime.
Whatsymptomsdobunionscause?Bunionscancausepainfulrubbingoverthebonyprominenceinfootwear.Thismakesfindingfootweardifficultandmaylimitactivities.Theycanalsobeassociatedwithpainelsewhereinthefootduetoalteredweightbearingcausedbythebigtoedeformity.Whatisthenon-surgicaltreatment?Youcantryshoemodificationwithwidershoestolimittherubbing.Splintsandspacersmaybehelpfulwhenworntopreventrubbing.Theywillnotcorrectthedeformitypermanentlyorpreventprogression.Whatisthesurgicaltreatment?Surgeryisthemostreliableandpermanentwaytocorrectyourbunion.Therearemanyoperationsusedforbunioncorrection.TheoperationusedbyMr.CurryistheScarf-Akinosteotomy.ThisoperationthewidelyusedinEuropeandAustraliaandavoidsmanyoftheproblemsassociatedwithotherbunionoperations.
Theoperationcomprises5parts
• Anincisionovertheinsideofthebigtoeismade.Thetissuesholdingthebigtoearereleased.
• Thebonyprominencefromthemetatarsalisremoved.
• Themetatarsalboneiscut(Scarfosteotomy)torealignthejoint.Thisisfixedwith2screws.
• Theproximalphalanxboneisthencut(Akinosteotomy)tocompletethecorrection.Thisisheldwithastaple.
• Thefinalpartoftheoperationistorepairandtightenthecapsulewherethebunionhasstretchedit.Thishelpstopreventrecurrence.
Whatisthesuccessrate?90%ofpatientsachieveasuccessfuloutcomeafterbunionsurgery.
Whatdoestherehabilitationinvolve?
• Youareinhospital1nightforonebunion
• Forthefirst2weeksyoushouldkeepyourfeetelevatedasmuchaspossibletominimizeswelling
• Youareabletobeginweightbearingimmediatelyinastiffsoledshoe.Hisshoeistobewornfor4-6weeks.Thereisnoplasterrequired.
• By6weeksyoucanbeginwearingwideoropenshoesandshouldbecomfortablewalkingaroundyourhouse.
• By3monthsyoucanbeginwearingnormalshoesandshouldbebacktorecreationalwalking.
• Swellingcantake6-9monthstoresolveandtightshoesmaybedifficultforthisperiod.
WhatifIhavebothfeetcorrected?Recoverytimeis50%longerwhenyouhavebothbunionscorrectedatthesametime.Willtheoperationbepainful?Youroperationwillusuallybedoneundergeneralanaesthetic.Toprovideongoingpainreliefyouranaesthetistwillperformanerveblockwhilstyouareasleepwhichnumbsthefootfor8-16hours.Sowhenyouwakeupyouwillhaveminimalpain.Astheblockwearsoffyouwillbegivenoralpainrelief.HowlongwillIbeoffwork?Thisisdependentuponyouroccupation
• Seatedjob 3-4weeks• Standingjob 6-8weeks• Heavyliftingjob 8-12weeks
WhencanIdrive?• Manualcar
o Nodrivingfor6weeks• Automaticcar
o Leftfootnodrivingfor2weekso Rightfootnodrivingfor6weeks
Whataretherisksoftheprocedure?Generalrisksofsurgery• Infectionandwoundhealingproblems• Nerveinjuryandscarsensitivity• Bloodclotstotheleg• Anaestheticproblems• Incompleteresolutionofsymptoms
Specificrisksforbunionsurgery• Stiffness• Recurrenceofdeformity
o 1%chanceperyearo 10%overyourlifetimeo Recurrenceisneverasbadasthe
originaldeformityandoftendoesn'trequiresurgery.
• Underorovercorrectionofthetoe• Painifarthritisispresent• BonesnothealingThisinformationisanoverviewofthemanagementofbunionsandisnotallinclusive.IfyouhaveanyquestionsregardingthispleasecontactMr.Curry’sroomson(03)99286188.