When a patient begins to experience the initial symptoms of hallux valgus, the prospect of undergoing surgery immediately becomes a concern.
Indeed, this condition, characterized by a deviation of the big toe towards the other toes, is challenging to treat. Surgery is often required to realign the bone to its correct position.
To reassure patients suffering from hallux valgus who have not found success with conservative treatments, I’ve decided to discuss the surgical procedure—how it works, its success rates, and the recovery times.
Continue reading to discover everything you need to know about bunion surgery.
What Happens If I Don't Have Hallux Valgus Surgery?
Some patients are so fearful of hallux valgus surgery that they avoid or continually postpone it. While this behavior may help avoid surgical stress, it doesn’t resolve the problem and can worsen foot conditions over time.
The disease progresses, leading to increased deformities of the big toe, swelling, irritations, and consequently, pain. The deviation of the big toe can make it challenging to wear normal shoes. Toes may overlap, causing friction and pressure on the tissue, necessitating the use of orthoses, which can impact both aesthetics and a patient’s psychology.
Hallux valgus can affect the biomechanics of the foot and lower limb, altering normal walking and weight distribution. This can result in increased pressure and stress on other parts of the foot and leg, leading to various problems such as arthritis of the foot joint, heel pain, and postural disorders affecting the back, shoulders, and neck.
In turn, this can limit the ability to perform daily activities such as walking or wearing common shoes.
In short, if the doctor suggests foot surgery, it is likely the solution that requires patience but offers the best results.
Now let’s delve into what hallux valgus surgery entails.
Bunion Surgery: Everything You Need to Know
The goal of correcting hallux valgus is to fix the deformity of the big toe. Thanks to this intervention, the patient will no longer experience pain, and the unsightly “bump” on the side of the foot will disappear.
Before the surgery, the surgeon will carefully assess the specific case and the extent of the big toe deformity, also requesting diagnostic tests such as X-rays or magnetic resonance imaging to evaluate the severity of the condition.
The patient will also be informed about the details of the operation and associated risks. There is no specific preparation for hallux valgus surgery, so the patient simply waits for the scheduled day of the operation.
How the Surgical Procedure Works
Surgery for hallux valgus correction can be performed using various surgical techniques:
- Osteotomy: This minimally invasive technique involves the surgeon making a cut in the metatarsal bone to move the big toe into the correct position. In some cases, small devices like screws or plates may be used to keep the bone in the new position until it heals correctly.
- Arthrodesis: In this operation, the surgeon removes damaged cartilage and positions the bone correctly. Subsequently, a combination of plates, screws, or metal wires is applied to stabilize the joint and allow fusion. Arthrodesis is used in extreme cases.
- Arthroplasty: This involves shaping the joint to resemble a healthy one, eliminating pain. In many cases, the operation can be performed using local or regional anesthesia. If the patient is anxious or prefers to be asleep, sedation may be administered.
All the described interventions have a duration ranging from 10 minutes to 2 hours. Timings depend on the chosen technique and the severity of the situation.
How Long Does It Take to Recover From Bunion Surgery?
After the surgery, the patient will be monitored in the hospital for a short period, sometimes overnight in more severe cases. For less invasive procedures, same-day discharge is expected.
The operated foot will be bandaged or immobilized with a brace to protect the area during the initial healing phase. During recovery, it is essential to follow the surgeon’s instructions for proper care of the operated foot. This may include elevating the foot, applying ice to reduce swelling, taking pain control medications, and participating in physical therapy sessions.
The surgeon will monitor the patient’s condition in the early postoperative period to ensure the intervention has had positive effects. Typically, recovery is divided into several phases and lasts approximately one month.
The patient can start walking immediately, not exerting too much pressure on the joint and not for long stretches. For at least a month, orthoses (post-operative shoes) must be worn. If necessary, the doctor may recommend the use of crutches.
Normality is restored only after 3 months of the operation. After 1 month, sneakers can be worn. After 3 months, high-heeled shoes and unrestricted sports activities are permitted.
How Long Does Pain Last After Bunion Surgery?
As mentioned earlier, what most frightens patients undergoing hallux valgus correction surgery is the postoperative pain. It is indeed a procedure that comes with pain but also excellent results.
Research and clinical studies have reported success rates ranging from 80% to 95%. The rate of complications is relatively high, ranging from 10% to 15%. However, accurate preoperative diagnosis can lead to satisfactory results and allow the patient to walk without difficulty.
Postoperative pain is typically attributed to tissue manipulation, removal or modification of bone and joint structures, and healing of surgical incisions. Patients describe it as acute, accompanied by pulsating burning and a sensation of warmth in the operated area.
The level of pain is usually more intense in the first few hours or the first two days after the surgery. It gradually decreases during the recovery period.
To find relief, the patient can take pain relievers and wait for the days to pass as the body reacts. The duration of pain can vary from individual to individual and also depends on the surgical technique used and the specific characteristics of the case. Generally, acute pain does not last more than 2 days and can be managed with pain medications.
Subsequently, the patient may experience feelings of discomfort, annoyance, or sensitivity in the operated area. Pain tends to gradually decrease over the following weeks.
How Much Does Bunion Surgery Cost?
Now, we come to a question that many patients ask and that often leads them to forgo the operation. Indeed, it is not an inexpensive procedure, but there are agreements with the National Health Service (NHS).
As a private patient, the cost of hallux valgus correction surgery ranges from €2500 to €5000, depending on the treatment, facility, and region. It is advisable to consult directly with healthcare facilities or specialized surgeons to obtain a more accurate estimate of costs.
Moreover, it is essential to consider insurance coverage, payment plans, financing options, or reimbursement possibilities through the National Health Service (NHS) or private insurance.
The important thing is not to give up the operation while waiting for the deformity to advance because more significant deformities have higher complication rates and less satisfactory results. I always advise patients to find a solution that does not require a financial burden but also provides a definitive cure for hallux valgus.
In many cases, the operation is performed only once and allows for permanent results. However, although rare, recurrences exist, mostly as partial recurrences. These can occur due to factors such as the progression of deformity over time, genetic factors, or structural foot problems. In some cases, additional therapeutic measures or subsequent interventions may be necessary to manage recurrences.
Furthermore, other complications may arise, such as joint stiffness, the formation of abnormal scars, instability of the corrected big toe, or the persistence of residual pain. Such complications may require additional treatments or corrective procedures.
Discuss these factors carefully with your doctor.
In conclusion, hallux valgus correction surgery is an effective surgical procedure to improve pain, functionality, and the aesthetic appearance of a foot affected by this deformity.
Before undergoing the operation, it’s essential to know that it’s not a “walk in the park”: it is indeed a painful procedure that requires a recovery period, although not extremely long. Everything depends on the technique the surgeon chooses to use on the patient and the success of the surgery.
Minimally invasive procedures are certainly preferable due to their low invasiveness and the shortened recovery times they can guarantee.
If you suffer from hallux valgus and can’t walk like before, I invite you to consider a visit to my orthopedic office in Florence. I am Dr. Vanni Strigelli, and for many years, I have been helping my patients regain their quality of life.
I am aware of the importance of personalized treatment and an appropriate recovery path. I work closely with my patients, providing an accurate assessment of their conditions, discussing treatment options, and offering a personalized care plan. Don’t wait any longer: contact me, and let’s schedule a visit.
Hallux valgus can be caused by genetic factors, structural foot problems, inappropriate footwear, or age-related factors. If the deformity causes persistent pain, difficulty wearing normal shoes, or significant limitations in daily activities despite conservative treatment, such as the use of orthotics or exercise, surgery may be necessary.
Common surgical techniques for hallux valgus correction include osteotomy, arthrodesis, and arthroplasty. Osteotomy involves cutting the bone to reposition the big toe. Arthrodesis involves fusing the joints involved in hallux valgus. Arthroplasty involves removing or modifying damaged joint parts. Of these, osteotomies are the most effective and commonly used.
The recovery period can vary depending on the complexity of the surgery and the individual patient’s response. Usually, it takes about 1 month, during which the bone heals. During this period, a postoperative shoe must be worn, and the foot is bandaged, with some patients using crutches for the first few days. Walking is allowed from the day of the surgery, leaning on the operated foot.
As with any surgical procedure, there are potential risks and complications. These may include infections, excessive bleeding, persistent pain, abnormal scarring, callus or corn formation, instability of the corrected big toe, aesthetic dissatisfaction, and recurrence of the deformity. It is essential to discuss these risks with the surgeon before the operation.
The primary goal of the operation is to correct the hallux valgus deformity, alleviate pain, and improve foot function. Success expectations vary depending on the specific case, the surgical techniques used, and the individual patient’s response. Most patients report a significant reduction in pain and improved foot function after the operation, but results may vary. The surgeon can provide more detailed information on the specific success expectations for the patient’s case.