A bunion, or hallux valgus, is a deformity of the joint at the base of the big toe. The first metatarsal bone drifts towards the other foot while the big toe angles towards the smaller toes, leaving a bony prominence on the inner side of the foot.
It is a change in bone alignment, not a growth of new bone, which is why splints and pads cannot reverse it. Surgery reliably corrects the alignment but is justified by pain and shoe difficulty, not by appearance alone.
Symptoms
- A bony bump on the inner edge of the foot at the big toe base
- Pain and redness over the bump from shoe pressure
- The big toe leaning towards, under or over the second toe
- Pain under the ball of the foot
- Corns, calluses and hammer toe of the second toe
- Difficulty finding shoes that fit
Causes and risk factors
The tendency is largely inherited through foot shape, ligament laxity and a mobile first metatarsal. Narrow, pointed or high-heeled shoes do not cause bunions by themselves but speed them up and make them hurt, which partly explains why women are affected far more often. Flat feet, rheumatoid arthritis, gout, generalised hypermobility and neuromuscular conditions add to the risk. Bunions in teenagers usually have a strong family pattern.
How it is diagnosed
- Clinical examination: Looks at toe alignment, joint movement, first ray mobility, the smaller toes and the skin.
- Weight-bearing foot X-rays: Standing films measure the hallux valgus and intermetatarsal angles, which grade severity and determine the type of operation.
- Assessment of joint arthritis: A stiff, arthritic joint (hallux rigidus) needs a different operation.
- Circulation and sensation check: Essential in people with diabetes or vascular disease before any surgery.
Treatment options
- Footwear change: Wide, soft, low-heeled shoes are the most effective non-surgical measure.
- Pads, spacers and orthoses: Relieve pressure and ball-of-foot pain. They do not straighten the toe.
- Distal osteotomy (chevron): A cut near the head of the metatarsal, fixed with a screw, for mild to moderate deformity.
- Scarf or proximal osteotomy: A longer cut allowing a larger shift for moderate to severe deformity, often with an Akin cut in the toe bone.
- Minimally invasive (percutaneous) surgery: The same bone cuts through incisions of a few millimetres under X-ray guidance. Scars are smaller. Results depend strongly on the surgeon's experience with the method.
- Lapidus fusion or joint fusion: For severe or unstable deformity, or when the big toe joint is arthritic.
When it is urgent
After surgery, increasing pain with a hot swollen calf, breathlessness, fever, spreading redness or wound discharge need same-day medical review wherever you are. A cold, pale or numb toe after a dressing or cast is applied needs immediate attention.
Travelling to Türkiye for treatment
Bunion correction suits a planned trip: surgery is a day case or one night, and you walk in a stiff-soled post-operative shoe from the first days. Allow 10 to 14 days before flying, keep the foot raised, and ask about clot prevention for the journey. Having both feet done together saves a trip but makes the first weeks much harder. Swelling lasts three to six months and X-ray review at about six weeks can be done at home.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
الأسئلة المتكررة
Will the bunion come back?
Recurrence occurs in a minority, more often after under-correction or with very flexible feet.
When can I wear normal shoes?
Wide trainers at around six to eight weeks. Narrow or heeled shoes may take four to six months, and some never feel comfortable again.
Is the minimally invasive method better?
Evidence shows similar correction with smaller scars. It is not suitable for every deformity.
Do night splints work?
They may ease discomfort but have not been shown to correct or halt the deformity in adults.