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Treatment options for bunion

NHS Choices Medical Reference

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Treatment Pros Cons
Special shoe insoles

Specially shaped shoe insoles, called orthoses or orthotics, reduce pressure on bunion and relieve pain

  • Short- to mid-term relief of pain (up to six months)
  • No side effects or complications
  • Pain often returns after six months
  • Does not improve appearance of foot
Surgery: part of bone removed
In a procedure called osteotomy, a small section of bone is removed from the foot. Remaining bones are then straightened
  • Relieves pain
  • Makes walking easier
  • Improves appearance of the foot
  • Long recovery time - it can take six weeks before weight can be placed onto affected foot
  • Will not prevent bunions from reoccurring
  • Can cause post-operative infection, small breaks in the bones that were operated on, loss of feeling in the big toe, stiffness, swelling and shortening of big toe
Surgery: toe bones fused

This is called arthrodesis. Two bones in the big toe are fused together; improving stability and alignment of bones, and reducing pain

  • May be an effective treatment for people who also have arthritis
  • Lack of evidence on whether technique is safe and effective in the long term
  • Loss of movement in the big toe, which could affect walking ability
  • Long recovery time - around four to 12 weeks
  • Can cause post-operative infection, pain, loss of feeling in the foot, failure of the fused bones to join properly
Surgery: half of toe joint removed

Known as Keller's arthroplasty, half the bones in the toe joint are removed. The remaining bones are straightened

  • May be effective in the treatment of very big bunions
  • May be an effective treatment for people who also have arthritis
  • Is often used when other surgical techniques fail to improve symptoms
  • Shorter recovery time than other types of surgeries - two to four weeks
  • Lack of evidence on whether technique is safe/effective in the long term
  • May be unable to move big toe properly
  • More than half of people who have a Keller's arthroplasty are unable to put the soft part of the toe on the ground when they walk (this is known as a 'cock-up deformity')
  • Can cause post-operative infection, joint stiffness, weakness and/or shortening of the big toe
Medical Review: April 17, 2010

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