BUNION SURGERY (Chevron or Scarf Osteotomy)

What is wrong with my foot?

Your big toe joint has moved out of alignment. This causes the big toe to turn towards your second toe causing a bony bump to stick out at the side of your foot. This bump may have become red and sore and is known as a ‘Bunion’. Sometimes the second toe also changes position and lies above or below the big toe.

Why has this happened?

Bunions are usually familial and more common in females. Wearing shoes that are too tight or being flat-footed may also contribute to the formation of a bunion.

Do I have to have an operation?

Pads, splints, foot orthoses and special shoes can be used to provide comfort but are unlikely to straighten the toe. If the bunion and big toe are still uncomfortable despite these measures then an operation will usually be recommended.

What will the operation involve?

The operation involves re-aligning the joint by creating a fracture to the bone behind the joint and sometimes in front of the joint as well. The bones are then moved into a straighter position. Tissues that are too tight around the joint are released and those that are too loose tightened. This is the operation chosen when there is little or no arthritis in the joint. The bony bump on the side of the toe will also be removed. The fractured bone(s) are held in place with a screw(s), which are not removed unless they cause problems. The surgery is performed under general or local anaesthetic. Both feet can be operated on at the same time if required but this does further limit your mobility during the first month after surgery. The foot will be heavily bandaged after the operation.

How successful is the operation?

90-95% of people are very satisfied with the results of the operation. They are able to wear normal shoes again comfortably.

Are there any risks associated with the operation?

As with all operations there are risks associated with the anaesthetic and surgery. Occasionally some patients may have complications such as infection, prolonged swelling, or recurrence of the condition. Sometimes the big toe is stiffer than before. Pain across the ball of the foot (metatarsalgia) can also develop although this usually settles with time. Following surgery it takes the foot a good 6 months to fully settle down.

What will happen after the operation?

The operation is usually day case but you may need to stay overnight in hospital. The Podiatric or Orthopaedic surgeon will discuss this with you. You will be given special shoes to wear over your bandages and you must wear these whenever you want to walk. The shoes must be worn for 4-6 weeks. You do not need to use crutches.

What happens when I leave hospital?

For the first 48 hours you will rest in bed with your legs elevated and should take the painkillers prescribed for you. You will be asked to do some foot exercises during this time. The bandages will be left on for 2-6 weeks. You will be given an Orthopaedic and Fracture clinic appointment to return to have the bandages removed. You will be able to return to work from 2-8 weeks after the operation, depending on whether you need to stand or walk around a lot for your job. You will not be able to drive until you come out of the post-operative shoe.