Hallux Valgus (Bunion)
Hallux valgus is a deformity in which the big toe deviates outwards, producing a painful prominence on the inner (medial) side of the foot. It may occur at a young age and is commonly associated with hypermobility, flat feet and a family tendency.
Symptoms
- Pain over the medial side of the big toe, particularly with footwear
- Prominent bony lump (“bunion”)
- In more severe deformity, crowding and deviation of the lesser toes
- Pain under the second or third metatarsal heads due to altered weight distribution
Investigations
- Weight-bearing plain X-rays are essential to assess the severity of deformity and the relationship between the first, second and third metatarsals
Treatment
Non-operative management
- Footwear modification (wide toe-box shoes)
- Activity modification
- Padding or splints where helpful
These measures relieve symptoms but do not correct the deformity.
Surgical management
Surgery is the definitive treatment when symptoms persist.
- Minimally invasive (keyhole/MIS) correction of the deformity
- In severe cases, additional procedures to the second or third toes may be required
- Patients can usually fully weight-bear immediately in a post-operative shoe
The aim of surgery is to realign the toe, relieve pain and improve shoe comfort while reducing the risk of recurrence.
