A bunion is a crippling bony bump that forms at the base of the big toe as a result of it deviating outwards towards the second toe. It can cause pain or difficulty in walking, and sufferers often have trouble finding shoes that fit. In 70 to 80 per cent of cases, bunions form on both feet.

Bunion plasters, inserts or splints can help ease pressure and relieve pain on the joint, but only surgery can correct the problem.

“Once the toe has deviated, it will not straighten again. It may get worse, and can lead to the overlapping of the second and third toes,” explain specialists from the Department of Orthopaedic Surgery at Singapore General Hospital (SGH), a member of the SingHealth group.

Bunion surgery as a treatment option

In the past, patients were often told to live with the problem, with bunion surgery the option of last resort. However, with new surgical methods, notably keyhole techniques, patients can walk almost immediately after the procedure.

“Many people think there is no cure for bunions, and if there is one, they think they will be on crutches for weeks or months. There are innovations to help them, and if they seek treatment early, these options are quite pain-free,” doctors explained.

Keyhole surgery vs conventional open surgery

If bunions are diagnosed at the less severe stage, they can be corrected by keyhole surgery. Keyhole surgery involves making five small cuts of just 2mm to 4mm each versus an incision of 5cm to 8cm that is required under conventional open surgery. These cuts are used by doctors to insert screws to reset the bones and keep them in alignment until they bond.

Undergoing either open or keyhole surgery usually involves an overnight stay at a hospital, as general anaesthesia is used. The patient can walk out of the hospital the next day with their bandaged foot protected by a tough sandal – there is no need for crutches. Recovery period is from two to four weeks.

With keyhole surgery, the procedure typically causes less pain and blood loss, with fewer wound complications and quicker recovery.

Pre-surgery preparations for bunion surgery

1. Fasting

Fasting is essential prior to surgery. In the event you did not follow the instructions, the surgery will be rescheduled. No food or drinks (except plain water) after midnight or as instructed. Last drink allowed is half a cup (100ml) of plain water.

2. Medicine

Certain medications need to be stopped in preparation for the surgery. Please inform your doctor of all medications you are on, especially blood thinners or herbal medications.

3. Additional instructions

• If you had a recent infection, be it involving the throat, lung, urinary tract or skin, it must be highlighted to the surgeon prior to surgery. Your surgery may be postponed
• If you are below 21 years old, consent for surgery will need to be given by a parent/legal guardian 

Post-op care for bunion surgery

1. Wound care

• Your doctor will apply your dressing in a specific way to keep the bones in correct position
• Keeping your toe in position is essential for successful healing
• It is very important to follow your doctor's directions about dressing care
• Do not change the dressing without consulting your doctor
• Be sure to keep your wound and dressing dry
• When showering, cover your foot with a plastic bag
• Referrals for change of dressing will not be given as you need to keep the existing dressing until the next follow-up

 2. Foot care

• Keep your foot elevated as much as possible for the first few days after surgery, and apply ice as recommended by your doctor to relieve swelling and pain. Never apply ice directly on your skin. It is common to have some swelling in your foot from 6 months to a year after bunion surgery
• After bunion surgery, you will be provided with a wedge shoe that you are to wear it at all times when you walk so that your full body weight will be on your heel
• Some bunion procedures allow you to walk on your foot right after the surgery. In these cases, patients must use a special surgical shoe to protect the bunion correction
• Follow the instructions from your surgeon strictly to prevent the bones from shifting and the bunion correction failing

3. Exercises

• Specific exercises will help restore your foot's strength and range of motion after surgery. Always start these exercises slowly and follow instructions from your doctor or physiotherapist regarding repetitions
• Avoid strenuous movements such as twisting; and high impact activities such as jumping and running 

Ref: M19

Check out our other articles on bunions:

Foot Bunion: Who Gets It and Why?

Pain Management Tips for Bunions