Orthopedics · Foot and ankle
Bunion and forefoot
Does the bump by your big toe hurt, and is it getting worse in shoes? Surgery removes the bump and returns the bones of the big toe to the correct position. At HR Clinic it is a day-surgery procedure. If everything is in order, it can take place as soon as within a week of the consultation.
- No referral from a primary care doctor needed
- Surgery by Prof. MUDr. Radek Hart
Procedure under general or regional anesthesia
- anesthesia
- generalor regional, depending on the procedure
- until the procedure
- 1 weekfrom the consultation, if everything is in order
- at the clinic
- 1 dayhome usually on the day of the procedure
- full recovery
- 6 monthsoften takes that long
01When surgery is considered
Bump, pain and pressure in shoes
A bunion (hallux valgus) develops gradually. The first metatarsal bone angles toward the inner side of the foot, the big toe turns toward the other toes, and the joint at the base of the big toe starts to stick out as a bump. In shoes it presses, swells and hurts.
-
Pain in shoes and when walking
A hard bump on the inner side of the foot at the big toe; the skin over it may be hardened, swollen or red. The side and the sole of the foot can also hurt, most of all in shoes and when walking.
-
It gets worse over time
The big toe can press on the second toe until it ends up under or over it. The smaller toes then deform into a hammer shape, and corns and calluses form where they rub against each other.
-
Who is at higher risk
Women more often than men, and people who have a bunion in the family; up to 70 % of people with a bunion do. Narrow, pointed shoes and rheumatoid arthritis also raise the risk.
-
Other forefoot problems
Other deformities of the front of the foot can also be operated on, for example hammer toes. The examination shows whether a basic forefoot operation is enough or a more extensive reconstruction is needed.
- foot outline
- bones
- axis of first metatarsal and big toe
- bump on the inner side
02When to operate
When surgery makes sense
Surgery is considered when the bunion hurts and limits you. Whether and when to operate is decided by the doctor at the consultation.
Symptoms
Pain limits daily life
In shoes, when walking and at rest.
- Pain limits walking and everyday activities
- The big toe stays swollen and inflamed even at rest
Findings
The big toe turns more and more
And starts pressing on the other toes.
- The big toe turns markedly toward the other toes or stiffens
- It presses on the second toe and the smaller toes deform into a hammer shape
Extent
Which operation
Based on the examination and X-ray.
- The examination shows whether a basic forefoot operation is enough or a more extensive reconstruction is needed
- Prof. Hart also uses minimally invasive techniques through small incisions, but they are not suitable for every finding
Not sure whether surgery is right for you? The examination decides; if you have diabetes, come sooner rather than later. Book a consultation
03How the procedure works
From booking to going home
The goal of the operation is to relieve pain and return the big toe to the correct position. It usually involves removing the bump, cutting and straightening the bone and securing it with screws or a plate, which often stay in the foot permanently. The soft tissues around the joint are adjusted as well. Which technique and extent suit your foot is explained by the doctor based on the examination and X-ray.
-
Booking
Online or by phone. A referral from a primary care doctor is not required.
online or by phone -
Consultation and examination
Prof. Hart examines the foot and, based on a weight-bearing X-ray, assesses how far the bones have shifted and whether the joint has been damaged by arthritis.
diagnosis and treatment plan -
Procedure
Under general or regional anesthesia. How long it takes depends on how much needs to be straightened.
within a week of consultation -
Home
Usually on the day of the procedure, with a bandage that holds the big toe in the correct position. You must not drive yourself.
checkups and physiotherapy
04Recovery and returning to shoes
Recovery takes patience
You spend one day at the clinic, but the foot heals over months. Full recovery often takes up to 6 months, mild swelling can last even a year, and you will come for checkups for several months. Exercises help restore the strength and mobility of the big toe; if needed, we continue with physiotherapy right at the clinic.
-
The first 2 weeks: rest
Rest as much as possible and keep the foot elevated; cooling also helps in the first days (never put ice directly on the skin). Do not remove the bandage and keep it dry. Stitches are removed after about 2 weeks.
-
6 to 12 weeks with support
That is how long the foot usually needs the support of a bandage or brace. Put weight on it only as instructed by the doctor: after some procedures you walk right away in a special post-operative shoe, after others the foot is not loaded for a while and you walk on crutches. You usually do not drive for 6 to 8 weeks.
-
Back into your own shoes
The doctor decides at a checkup when you can move to regular footwear. Plan on a wide shoe with a soft sole and a low heel. The operation does not mean you can go back to a smaller shoe size or narrow pointed shoes, and tight footwear can bring the bump back.
-
Work and sports
Time off work usually lasts 2 to 12 weeks; plan on sports after 3 to 6 months. You will get a more precise estimate for your job and your level of activity at the consultation.
05Who operates
Prof. MUDr. Radek Hart, Ph.D., FRCS, MHA
Orthopedic surgeon and trauma specialist of the musculoskeletal system, chief physician of HR Clinic. At a clinic in Vienna he is head of the foot outpatient clinic. He sees patients in Znojmo and in Vienna; after a consultation in Vienna the procedure can be performed in Znojmo.
More about Prof. Hart Professional site ortho-hart.at
Price We will tell you the price of the procedure at the consultation, depending on the findings and the extent of the procedure.
06Common questions
What patients ask most often
Will the operation hurt?
You feel nothing during the procedure. Under general anesthesia you sleep; regional anesthesia numbs the part of the body being operated on. Afterward medication eases the pain, and keeping the foot elevated and cooling it also help. If the pain does not start to improve within a few days, contact us.
When will I be able to walk?
It depends on the chosen technique. After some procedures you can walk right away in a special post-operative shoe, after others the foot is not loaded for a while and you use crutches. You will get the exact plan before the procedure. Do not put weight on the foot sooner than your doctor allows; the bones could shift.
How long will I stay at the clinic?
You usually go home on the day of the procedure. The stay at the clinic lasts 24 hours at most.
Can the bunion come back?
In most people the pain eases after surgery and the big toe is straighter. A bunion can sometimes come back, mainly when returning to narrow, tight shoes. The big toe may also not be completely straight and may be weaker or stiffer than before.
Do you operate minimally invasively?
For bunions Prof. Hart also uses minimally invasive techniques through small incisions. They are not suitable for every finding, though. He recommends which technique suits your foot based on the examination and X-ray.
Do I need a referral from a primary care doctor?
No. Just book online or by phone.
How quickly can I have the procedure?
If everything is in order, the procedure can take place as soon as within a week of the consultation. We arrange the date according to the examination results.
07Booking
Book an orthopedic consultation
Online or by phone, at the clinic in Znojmo. A referral from a primary care doctor is not required.
- +420 515 225 520
- info@webdemo.dam-medizin.com
- Kotkova 3974/9c, 669 02 ZnojmoMon: 8:30–15:00 · Tue–Fri: by appointment
