1. Mr S Finney Consultant Podiatric Surgeon What is a Bunion ?  A bunion is a deformity of the forefoot which to the suffer appears to be a enlargement of the big toe joint.

2. Mr S Finney Consultant Podiatric Surgeon What are the symptoms/concerns ?  Pain At the site of the bunion At the site of the bunion At other areas of the foot At other areas of the foot At areas away from the foot e.g. postural At areas away from the foot e.g. postural  Reduced function and mobility  Footwear problems.  Concern that deformity will worsen in time and impact mobility  Cosmetic appearance

3. Mr S Finney Consultant Podiatric Surgeon What are the treatment options ?  Tolerate.  Accommodate.  Operate.

4. Mr S Finney Consultant Podiatric Surgeon Accommodate Footwear Protective shields

5. Mr S Finney Consultant Podiatric Surgeon Operate  There are over 100 hundred different operations described to correct bunions. This fact if nothing else demonstrates that there is no one fix for all.  Current thinking favours tailoring the operation to the individual requirements.  Broadly speaking there are three options if surgery is required.

6. Mr S Finney Consultant Podiatric Surgeon  For small bunions or bunions where pressure from shoes is the main symptom a bunion shave or bunionectomy may be appropriate.

7. Mr S Finney Consultant Podiatric Surgeon  For medium or large bunions where a shave alone is unlikely to offer lasting benefit then a midshaft osteotomy is usually performed.

8. Mr S Finney Consultant Podiatric Surgeon  For severe bunions it is sometimes necessary to come further back into the foot to correct the deformity. Usually this involves fusion one or more of the joints in the midfoot or arch of the foot.

9. Mr S Finney Consultant Podiatric Surgeon Rehabilition  In the vast majority of cases we ask patients to return to a roomy shoe such as a trainer after the 2 nd redressing at around 2 weeks.  Audit suggests that the majority of people can retrun to their normal footwear by 8 weeks post-operatively

10. Mr S Finney Consultant Podiatric Surgeon Risks  Any surgery carries the risk of a complications which can either delay recovery or render you permanently worse. Such risks include:- Failure of operation Failure of operation Recurrence of deformity Recurrence of deformity Infection Infection Deep vein thrombosis Deep vein thrombosis Ongoing pain and swelling at the operation site. Ongoing pain and swelling at the operation site.  Not having this surgery may also constitute risk e.g. Missed window of opportunity to have surgery. Missed window of opportunity to have surgery. Progression of deformity and effect on other parts of the foot. Progression of deformity and effect on other parts of the foot. Altered gait patterns resulting in muscular skeletal and postural symptoms Altered gait patterns resulting in muscular skeletal and postural symptoms

11. Mr S Finney Consultant Podiatric Surgeon Should I have surgery?  Ultimately whether or not you undergo surgery is your decision.  In order to make the decision you should take the time consider the benefits of the surgery benefits of the surgery the risks and rehabilitation the risks and rehabilitation the risks of not having surgery the risks of not having surgery

12. Mr S Finney Consultant Podiatric Surgeon Before and 2 weeks after