Hallux Valgus

Hallux valgus surgery – Metatarsal osteotomy

You have been recommended an operation to correct the angulation of your big toe. This angulation is caused hallux valgus and the lump on the inner side of the foot is called a bunion.

  • The aim of surgery is to improve pain and function as well as the appearance of the toe.
  • Surgery will be performed under a general anaesthetic and for traditional surgery there will be two scars, one along the inner border of the foot and one at the base of the first and second toes.
  • For MIS (Minimally Invasive technique) only stab incisons are used to minimise the scarring
  • The metatarsal bone will be cut and moved and then stabilised with one or two metal screws. These screws will remain in situ permanently.
  • A second bone cut may be required in the bone at the base of the big toe in order to complete the correction.
  • The joint will be repaired with stitches to ensure correct alignment and movement of the joint.
  • You will be in hospital for one night and will mobilise the morning after surgery with the help of physiotherapists.  You will wear a special heel-bearing shoe, which relieves weight from the forefoot.
  • You will be seen in the Outpatient Clinic at one week in order to check the wounds and trim the stitch ends.
  • You will require an X-ray at six weeks after surgery to ensure the bones have healed.
  • In the first week after surgery you are advised to keep your foot elevated as much as possible in order to minimise swelling.  Thereafter you will be able to gradually increase the amount that you walk, depending on the amount of pain and discomfort in the foot. Most people require pain relief in the first week and less so in the second week. It is not usual to require pain relief after this period of time, although on occasions patients do require intermittent painkillers for a longer period.
  • Once you have had an X-ray at six weeks you will be allowed to mobilise using more normal footwear as swelling allows.  The swelling resolves usually by eight to twelve weeks after surgery.
  • Occasionally complications occur as in any operation. There is a risk of infection, which is less than 1%.  If infection occurs antibiotics will be prescribed.  Very rarely infection will involve the bones which may require more aggressive treatment such as washing the wounds under a further anaesthetic. Occasionally there may be nerve injury during the operation such that you have numbness or pins and needles along the toe. This is usually temporary although on occasion may persist permanently. This usually does not cause problems however.
  • The end point for recovery is broadly between six and nine months. From three months you will be walking independently with comfort and very few problems.  You are advised not to drive until an X-ray has confirmed the bones have healed.

Post-operative Program

The Podalux shoe has a removable stiffener that is used to change the stiffness of the sole for different stages following surgery.

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