Foot and ankle update - minimally invasive bunion surgery
Friday 24 March 2017

I consider the bunion to be like an onion! They can make you cry and have many layers. Hence they are quite complex needing careful and expert assessment and in most cases surgery.

If you are reading this you are probably suffering with bunions or considering surgery and hopefully this article will help you make an informed decision.

The foot can be a complex beast and I feel it is crucial to marry the story (history) of the problem with the symptoms (clinical signs). There can be other problems that show themselves as bunions. These can be from painful or arthritic joint to a flat foot (tibialis posterior tendon dysfunction) which has led to the bunion  and hence needs consideration when making a plan. There can be a whole host of further differentials in between.

My background is as a medically qualified and surgically trained sub-specialist in both orthopaedics and sports medicine. My training and practice allows me to holistically manage all aspects of this problem and all of the medical and recovery factors around it. My aim is to convey and predict what you have and how I can help.

I believe less is more and aim to correct this troublesome problem with a view of less pain and a quicker recovery. My practice covers both open and minimally invasive surgery. The former is well recognised and the later is quite specialised. I am fellowship trained by a national leader in Australia who I believe to have perfected the technique that I enjoy using. Not only does MIS surgery result in smaller scars but as less tissue and bone is disrupted there is less to cause pain during recovery and less to cause recognised problems in healing thus a much happier and speedy recovery!

The problem is that of the long foot bone to the great toe (1st metatarsal) moving inwards (medially) and the great toe itself pulling out (valgus deviation). The big toe also rotates inwards and you may notice the nail pointing in rather than up where it once was. On the X rays we see the head on this bone which is quite round pushing on the soft tissue shadows (skin) and creating the feeling of the bump or bunion. As it does this the big toes rolls in and sometimes pushes the second toe up and out the way. This crossing over can lead to a very sore second toe and can easily be corrected and made straight with surgery. At the same time the second metatarsal or long bone in the foot can feel quite long as the first one moves in. Its not actually getting longer but appears that way as the first one slopes off. This can lead to quite thick skin and tenderness on the sole of the foot at the end of this bone called transfer metatarsalgia. Again this can be easily dealt with in surgery. Often the sole problem is the bunion and more often than not you can relate this back to a family member also have bunions.

Hopefully this is painting a picture with some familiarity. The message is of hope and solutions and as you can see expert consideration to get the right result!

If dealt with properly the bunion can be treated well and once again give you a well shaped, better functioning and painless foot!

If you would like to book a consultation with Mr Kunasingam, Consultant Orthopaedic Surgeon, please contact us either by using the online form or on 0800 0468 036.


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