Foot and ankle

Hallux rigidus is a common condition where your big toe becomes stiff, limiting its movement. It’s often caused by arthritis – and, over time, the toe joint can become increasingly painful and swollen. If you have hallux rigidus, you might also have a painful lump on the top of your big toe joint, which is sometimes called a dorsal bunion. This can make it painful to wear shoes. 

Surgical treatment options for hallux rigidus include both traditional surgery (known as a cheilectomy) and keyhole surgery. While they are performed differently, both procedures aim to reduce or eliminate pain and improve joint mobility by removing the ridge of arthritic bone.

What is a bunion? 

A bunion is a bony lump on the side of your big toe. They can be very uncomfortable or even painful, as wearing shoes often puts pressure on them and causes them to swell. 

A bunion appears when the foot bone connecting to the big toe moves gradually in towards the opposite foot. The technical term for this is a hallux valgus deformity, and over time it forces the big toe to push in towards the second toe. Left untreated, the big toe could eventually push in so far that it and the second toe become crossed. 

How are bunions treated? 

Bunions can be treated both surgically and non-surgically. Non-surgical options include wearing bunion-friendly shoes such as sandals, shoes that have wide toe boxes, or ones with soft, moulded insoles. It might also be possible to have your leather shoes relaxed to make room for your bunion. 

In more severe cases, a doctor might recommend bunion surgery. The aim of surgery is to remove the bunion/s and, if necessary, realign the toes. The surgeon might also implant screws to hold the bones in place. These screws are designed to be permanent – you should not feel them. 

Reconstruction surgery is sometimes recommended for people who experience recurring ankle sprains even after a course of regular physiotherapy. Each ankle sprain increases the risk of permanent injury to the ankle, such as joint damage or arthritis. Ankle reconstruction surgery aims to strengthen the lateral ligament, which is responsible for stabilising the ankle joint.

Some people who need reconstruction surgery have other ankle issues too, such as joint surface damage, synovitis, bony impingement spurs, or even loose bone or cartilage fragments. They might also need an ankle arthroscopy, which can sometimes be performed at the same time as a ligament reconstruction.