Bunion Surgery
What is Bunion Surgery?
Bunion surgery is a type of surgery that is performed to correct a bunion. Bunion (Hallux Valgus) is a foot deformity / bony bump that results in prominence of the inner part of the big toe joint, in particular at the base of the joint where the big toe meets the first metatarsal bone. Bunions can cause pain, swelling, and difficulty walking, and may become worse over time if left untreated.During bunion surgery, the Bunion surgeon may remove some of the bone or tissue from the affected joint to realign the toe and relieve pressure on the bunion. The procedure may involve making an incision in the skin over the bunion, and then cutting and repositioning the bones to correct the alignment.
There are several different types of bunion surgery, and the specific procedure used will depend on the severity of the bunion and the individual patient’s needs. Recovery time for Bunion Surgery can vary depending on the type of surgery performed and the extent of the correction needed. It is important to discuss the risks and benefits of bunion surgery with your doctor to determine whether it is the right option for you
Our bunion surgeon, Mr Kaser Nazir, specialises in the minimally invasive bunion surgery. We will outline further details on the types of bunion surgery and what it involves, including postoperative recovery from Bunion Surgery week by week and typical pricing for bunion correction in London, UK.
What are the Advantages of Bunion Surgery?
A bunion, or hallux valgus deformity, affects the big toe. The aim of bunion surgery is to:- Completely correct the underlying misalignment of the bones and ligaments causing the deformity.
- Appropriately realign the joint to ensure minimal risks of recurrence of the bunion.
- Improve function
- Relief from pain
- Cosmetically pleasing appearance
Mr Kaser Nazir demonstrates the minimally invasive bunion surgery technique
Types of Bunion Surgery
There are several different types of bunion surgery, and the specific procedure used will depend on the severity of the bunion and the individual patient’s needs. Some common types of bunion surgery Our central London based bunion surgeon, Mr Kaser Nazir, primarily assists with:- Minimally invasive bunion Surgery, also known as “Keyhole Bunion Surgery”.
- Scarf and Akin Osteotomy
- Lapidus Procedure for more severe bunions
Bunions: Diagnosis, Cause and Treatment
Bunions often develop over a long period. They are progressive, meaning that without intervention a Bunion will get worse over time. A Bunion will typically first appear as a mild bump below the big toe that protrudes out from the foot. As it develops the bony bump may become more severe, causing irritation in footwear, redness and inflammation. As the joint deviates further, the big toe may start to underride or overlap the adjacent toes, causing further issues and painful symptoms. Know more about Bunions: Diagnosis, Cause and Treatment A bunion or hallux valgus deformity is more common in women than men and is often a hereditary issue. Bunions can also be caused by narrow fitting footwear or high heels, where the toes can be pushed together and put pressure on the big toe. It is worth visiting a podiatrist or a foot surgeon specialising in bunion surgery when you see a bunion starting to develop, they can assist with advice and conservative treatment including:- Custom orthotics
- Toe splints
- Advice on appropriate footwear
Bunion Symptoms:
Clinically signs of a bunion include:
- Swelling, redness or pain around the big toe joint
- A bump at the side of the base of your big toe
- Pain under the ball of the big toe or often the second toe due to the bunion pushing it over
- Widening forefoot
- Difficulty wearing closed shoes comfortably
- Bone displacement
- Joint swelling
- Bone overgrowth
- Big toe joint arthritis
- An increases angle of the hallux valgus (big toe)
- An increased angle between the first and second metatarsal, thus a wide foot
- Flat foot associated with bunion
- Quality of bone and osteoporosis
- Minimally invasive bunion correction or keyhole bunion surgery for most bunions with good quality bone and minimal or no arthritis evident on X-rays.
- Scarf and akin osteotomy for mild to moderate bunions, very slim bones or with osteopenia.
- Lapidus procedure for severe bunions deformities with arthritis of the midfoot or severe hypermobility (least common).
- Big toe joint fusion for those with arthritis and bunion deformity of the big toe (rare).
Types of Bunion Surgery
Minimally Invasive Bunion Surgery, also known as Keyhole Bunion Surgery, uses specialised burrs that are used to cut and reset the metatarsal and proximal phalanx bone into a corrected alignment alongside specially designed screws through very small incisions.
Mr Nazir typically uses the PECA bunion correction system. The procedure is carried out with the aid of an X-ray machine and specialised instrument to accurately calibrate the required bunion correction. This allows the bunion surgeon to make three – four 2mm incisions and minimises the damage to the soft tissue.
Step 2: The head of the first metatarsal is repositioned, to minimise the bony prominence. The Pecaplasty jig device is used to secure the corrected bones temporarily and checked on X-rays.
Step 3: Two screws are used to fix both sections of the metatarsal in its new position.
Step 4: A wedge is sometimes removed from the first proximal phalanx to reposition the big toe into a straighter natural alignment if required. This is also fixed in place with a screw.
Step 5: The protruding bone is cut away and flattened to a natural outer arc.
Advantages of the minimally invasive bunion surgery include:
- Less downtime
- Less swelling
- Minimal postoperative pain
- Less chance of joint stiffness due to reduced trauma
Why is a screw fixation still required for the minimally invasive bunion correction?
Research shows that without a fixation keeping the joint in place once the bones have been realigned increases the risk of complication such as delayed or non-union of bones and recurrence of the deformity. Using the PECA correction system with screws significantly reduces the chance of the bunion recurring and predictable recovery, including immediate weightbearing with minimal pain and swelling.Steps of the minimally invasive bunion surgery
Step 1: A small 2mm incision is made on the inner side of the foot allowing the first metatarsal to be cut using a cutting burr known as a Shannon.
Step 2: The head of the first metatarsal is repositioned, to minimise the bony prominence. The Pecaplasty jig device is used to secure the corrected bones temporarily and checked on X-rays.
Step 3: Two screws are used to fix both sections of the metatarsal in its new position.
Step 4: A wedge is sometimes removed from the first proximal phalanx to reposition the big toe into a straighter natural alignment if required. This is also fixed in place with a screw.
Step 5: The protruding bone is cut away and flattened to a natural outer arc.
Recovery following the minimally invasive bunion surgery
The scarf and akin osteotomy is a one of the most popular types of bunion surgeries as it:
Step 2: The Bunion prominence is shaved using a bone saw.
Step 3: Metatarsal bone is cut and joint is realigned, then screwed in place using 2 titanium screws.
Step 4: A small wedge is removed from the phalanx to straighten the end of the toe (Akin Osteotomy)
Step 5: The phalanx is fixed together with a further titanium screw where the wedge has been removed, promoting a correct alignment of the toe
- Restores foot mechanics
- Allows for correction of small and moderate deformities
- Low recurrence rate
Steps of the scarf and akin osteotomy
Step 1: An approximately 8cm incision is made on the inner side of the bunion joint. The soft tissues are released to expose the bunion joint.
Step 2: The Bunion prominence is shaved using a bone saw.
Step 3: Metatarsal bone is cut and joint is realigned, then screwed in place using 2 titanium screws.
Step 4: A small wedge is removed from the phalanx to straighten the end of the toe (Akin Osteotomy)
Step 5: The phalanx is fixed together with a further titanium screw where the wedge has been removed, promoting a correct alignment of the toe
Recovery following the scarf and akin osteotomy
The Lapidus procedure is carried out to correct more severe bunions or for patients who have a bunion and suffer from hypermobility. Patients who are hypermobile have an increased chance of recurrence following other bunion techniques.
Steps of the Lapidus procedure
Step 1: An incision is made at the side of the foot measuring 13-15cm. Step 2: The soft tissues around the bunion and midfoot joint are released to expose both the big toe bunion joint and the midfoot joint. Step 3: The bony growth of the inner bunion is removed using a bone saw. Step 4 The joint near the instep (tarsometatarsal joint) is removed, realigned and fused with a fixation which includes screws and a plate.Recovery following the Lapidus procedure
Bunion Surgery Costs
Mr Kaser Nazir is covered by all major insurance companies. If you plan on using medical insurance please contact your provider and request authorisation for a consultation and X-ray. Following your appointment, our team will provide you with details on how to authorise the surgery. If you are privately funding your appointments and procedure, the cost of bunion surgery will depend on which type of bunion surgery is recommended. This will vary depending on the severity of your bunion. Below is a guide to the bunion pricing:
Consultation with Mr Kaser Nazir: £250
Preoperative X-ray one foot: £160
Bunion correction for one foot under sedation:
Minimally invasive bunion correction: From £5,732
Scarf and akin osteotomy: From £5,395
Lapidus procedure: £8,255
Postoperative X-ray one foot: £160
Please note that the above fees are approximate, fees may change depending on Mr Kaser Nazir’s recommendations.
The Lapidus procedure will require additional postoperative fees including cast changes and an aircast boot.
Find out further pricing information through our quote generator
Contact our team on 02078208007 or email admin@londonfootandanklesurgery.co.uk if you have any questions regarding pricing.
Bunion Surgery: Frequently Asked Question
Bunion surgery can be covered by your medical insurance. The first step is to contact your GP who can provide a referral, your insurance provider will require this in order to authorise a consultation and X-ray with Mr Kaser Nazir. Following your appointment, our administrative team will contact you to provide all details required in order to authorise the surgery. Some international policies may not require a GP referral or may recommend a chat with their in-house clinical teams to authorise a consultation for bunion surgery with Mr Nazir.
Keyhole bunion surgery, or minimally invasive bunion surgery, is a modern technique to surgically correct a bunion. The procedure is carried out with the aid of a live X-ray machine to cut and reset the bone malalignment using 3-4 small 1 to 3mm incisions to guide the specialised surgical instruments and fix the bones in the corrected position using specialised screws designed for bunion correction.
As there is minimal scar tissue, the area heals much quicker than more traditional bunion correction. Mr Kaser Nazir has seen excellent results with his patients who have reduced pain and quicker recovery.
The cost for minimally invasive bunion correction will depend on exactly what your surgeon suggests following a consultation and X-rays. The fee is approximately £6000 under sedation for one foot and £9000 under sedation to correct both feet at the same time. The cost can vary a little depending on whether the procedure is done under local anaesthesia, sedation or general anaesthesia. The bunion procedures are usually day case procedures meaning that you will not be required to stay overnight.
Mr Kaser Nazir is the leading bunion surgeon based at 17 Harley Street in central London. He specialises in the minimally invasive/ keyhole bunion correction and is internationally recognised for performing this operation.
The simple answer is yes. Following the minimally invasive bunion surgery, you will require a postoperative shoe and possibly crutches to help mobilise. Walking will be limited to 5 to 10 minutes an hour for the first 5 days. It is important to rest as much as possible over the first few days to promote healing and reduce swelling that allows quicker long term recovery. After 5 days you can gradually increase mobilisation over the next 2 weeks and wear trainers 2 to 3 weeks following the bunion operation depending on post operative swelling.
Bunions are a progressive deformity. Though there are ways to reduce how quickly the bunion deteriorates, such as a splint, custom orthotics or wider footwear, bunion surgery is typically required in the long run. Most bunion deformities will progress over time.
Unfortunately, there is no way to shrink or reverse a bunion without surgical intervention. Splints, custom orthotics and wider footwear can slow how quickly the bunion deteriorates but will not correct or reduce the size. Anti-inflammatory medication can be used to manage acute symptoms in the short term with wide supportive footwear.
Your surgeon will initially advise on a postoperative shoe and crutches to aid with mobilisation over the first two weeks, though it is important to rest as much as possible over the first few days. After two weeks you will be able to return to most normal activities, excluding high impact activities. Typically longer walks are allowed after 4 weeks and high impact after 8 weeks.
Discomfort from a mild bunion can be helped with a toe splint, custom orthotics or wider footwear. Some mild bunions can also require surgical intervention if they are painful.
It is not possible to correct or reverse a bunion without surgical intervention.
A bunion procedure is carried out to correct and realign the affected bone.
There are a few procedures that may be suggested, such as the scarf and akin osteotomy or lapidus procedure for more severe bunions. Mr Kaser Nazir, however, can carry out the minimally invasive/ keyhole bunion procedure that provides an excellent cosmetically pleasing result, with reduced pain and recovery.
Alternatives to bunion surgery may include a toe splint, custom orthotics or wearing wider fitted shoes. Ultrasound guided steroid injections can also assist with pain management. These options will not however correct the bunion. The only way to correct a bunion is with surgical intervention.
Early signs of a bunion may include:
- Swelling, redness or soreness around the big toe joint
- Limited movement of the big toe
- A bump on the outside of the base of your big toe
- Stiffness in the big toe joint
- Pain under ball of second toe due to overloading