A bunion is a swelling on the side of your big toe joint that’s caused by neighbouring toes leaning towards each other. It’s a common foot problem, medically known as hallux valgus.
The bony lump is prone to rubbing from shoes, and causes inflammation, pain and difficulty walking. If you’ve a bunion you may find it difficult to find shoes that fit well.
Often non-surgical treatments are recommended to relieve pressure on your foot. Comfortable, well-fitting shoes may alleviate pain or an orthotic device can be inserted into your shoe to prevent the condition from worsening.
Sometimes bunion surgery is necessary to improve the function and appearance of a big toe. If this is the case our podiatric surgeon will remove the bony lump and straighten your big toe.
Osteotomy is a surgical procedure where a bone is cut to shorten, lengthen, or change its alignment. Our podiatrist performs an osteotomy on a bunion, or to straighten a bone in the toe in crowded or splayed toes.
There are two types of osteotomy:
- Metatarsal osteotomy – removal of a small wedge of bone from the foot.
- Phalangeal osteotomy – removal of a small piece of bone from the toe.
During osteotomy surgery for bunion treatment, your podiatric surgeon will remove the bony lump and realign the bones inside your big toe. They’ll also move your toe joint back in line, which may require the removal of other pieces of bone, possibly from the neighbouring toes.
Claw and hammer toes
Claw and hammer toes are deformed lesser toes (all toes except your big toe). They can be painful as well as unattractive.
Claw and hammer toes are caused by a tendon in your foot contracting and pulling one of your lesser toes. It can be brought on by wearing ill-fitting shoes or a muscle imbalance.
If you’ve a claw toe your first bone is raised and the second two bones point downwards resulting in your toe looking like a claw. If you’ve a hammer toe your first bone is slightly raised, the second bone tilts downwards and the end bone is almost flat and it looks like a hammer.
Initially your podiatrist will recommend changing your footwear, trying orthotics, regularly doing foot exercises and using splints or medicines.
Often surgery if required to straighten claw and hammer toes. Your podiatrist will discuss the surgical options best suited to your needs. Surgery can release the trapped soft tissue and lengthen your tendon or the middle joint can be fused together.
Fusion is the surgical joining together of joints and can be used for most joints in the foot and ankle. It immobilises painful, worn down joints and creates a single joint structure.
Fusion is very effective at eliminating persistent pain usually caused by arthritis or trauma, it’s highly durable and is often performed on younger patients who wish to remain active. It’s normally recommended if more conservative treatments have been unsuccessful as it can cause some loss of mobility.
Common fusions we perform are:
- Ankle fusion – also called ankle arthrodesis. It’s a surgical treatment for advanced ankle osteoarthritis.
- Hind foot fusion – also known as rear foot fusion. Fusion of a number of joints to treat arthritis or to correct a foot deformity, such as clubfoot.
- Big toe fusion – surgery to fuse the joint in the big toe if you have the common problem called hallux rigidus or stiff big toe.
In growing toenail
In growing toenails are a common problem and can happen to any of your toes. An ingrowing toenail develops when the side of your toenail cuts and grows into the skin next to your toenail. The skin around your toenail can then become inflamed and painful.
An ingrowing toenail may be caused by badly cut toenails, wearing tight fitting footwear, sweaty feet, injury or the natural shape of your toenail being more curved or fan-shaped.
Non-surgical options will initially be recommended such as hygiene, nail cutting and footwear advice. If this doesn’t help, then surgery may be required. Surgery, called nail avulsion, removes all or part of your toenail. Partial nail avulsion is most frequently used for treating ingrown toenails. If your toenail is thick and pressing into the skin surrounding your toe, then total nail avulsion may be necessary.