We don’t entirely know why some people develop bunions but others don’t.  There is probably a genetic component to it, and certain foot types, such as high arched feet, flat feet and hypermobile feet, can predispose a person to bunions.  It tends to be more common in women than men. Fundamentally, bunions form as result of failure of soft tissue, and if you frequently wear high heels and narrow pointed shoes, you will increase the stress on those finely balanced tissues and increase your chances of developing a bunion.

Bunions aren’t a trivial or purely cosmetic problem. They can cause real suffering and can affect your walking. Once you have a bunion, it’s likely to get slowly worse over time. Wearing broader shoes may give some comfort, but I find that toe separators or splints of little help as they tend to cause sweating and skin irritation and don’t fit easily into shoes. If your bunion is causing day to day problems, it may be time to consider surgery.

This cutting-edge minimally invasive (keyhole) bunion correction surgery is setting new standards in foot care technology. This advanced technique offers several benefits for patients, including reduced scarring, minimal tissue damage, and less post-operative pain and stiffness.

This innovative approach involves making only 2 to 4 very small skin incisions measuring approximately 3mm each. Through these incisions, specialised high-tech burrs are utilized to perform precise bone cuts (osteotomy), realigning and stabilizing the toe. The surgical process is guided by frequent X-rays, which ensure accuracy and help in performing the necessary bone cuts.

The technique of minimally invasive bunion surgery is continuing to develop over time, benefitting more and more patients.

It’s essential to appreciate that not all bunions are created equal, and while most can be effectively treated with minimally invasive techniques, some patients may require alternative approaches to achieve optimal results.

This is a bunion surgery that’s designed to straighten the big toe, and correct excess movement (hypermobility) through the 1^st tarsometatarsal (TMT) joint that contributed to the bunion’s formation. It’s essentially a bunion correction and a fusion of the joint between the first metatarsal bone and the medial cuneiform bone behind it. In some patients who have hypermobility and a big deformity, this kind of surgery is necessary.

If you have a severe bunion and are finding it difficult to get shoes to fit, it’s a sign you may have first TMT joint hypermobility that will need stabilising along with your bunion surgery. This will give you the best possible chance of reducing the risk of the bunion returning.

I regularly perform this kind of surgery in the adolescent age group, but in less than 10% of adults.

An incision is made along the side of big toe, and cuts are made to prepare the joint for fusion and realign the toe, fixed in place by a plate and small screws. In adolescents, particularly those with hypermobility, this surgery may need to be combined with other surgeries.

My team and I do everything we can to make your surgery as safe as possible, and complications such as bleeding, blood clots, infection and anaesthetic issues are thankfully rare.  Very occasionally, if a patient does too much, too soon, in terms of weight bearing, there may be delayed wound healing, and some patients may experience some numbness around the incision sites, which typically improves over a few weeks. Big toe stiffness can be a potential problem, which is why it’s really important to work on mobilising the toe after surgery.