Foot Focus Podiatry

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08 9258 4152 |
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Bunion Treatment in Perth

Do you suffer from painful bunions?  Do your bunions stop you from normal daily activities?  Please read on for how we can help you.

Bunion (Hallux Valgus), is one of the most common forefoot problems.  It is a prominent bump on the inside of the foot around the big toe joint.  This bump can rub inside shoes causing pain and inflammation.

Before and after Bunion Surgery

Bunion-before-e1593135271573 Bunion / Hallux ValgusBunion-after-e1593138382552 Bunion / Hallux Valgus

Bunion treatment depends on the severity of the condition.  The discomfort of mild bunions can be relieved by simply changing shoes, medication, orthotics and physical therapy . Surgical treatment is usually reserved for cases that do not respond well to these measures.

We advise seeing one of our general podiatrists first for a complete medical and biomechanical assessment and explanation of any conservative treatments that may be performed prior to seeking a surgical opinion.

Surgery to treat bunions (see examples 1 and 2 below) is often used for severe cases, or after conservative treatment has been ineffective. There are several different surgical options available, depending on the cause and symptoms of the bunion.  Dr Naraghi has research publications in bunion surgery and management.

A New Measure of Tibial Sesamoid Position in Hallux Valgus in Relation to the Coronal Rotation of the First Metatarsal in CT Scans is one of the researches that he has co-authored and supervised has led a new classification system for assessment and management of bunion deformity worldwide. The results perhaps explain why certain bunions re-occur as a result of not addressing the frontal plane rotation of the first metatarsal. The hallux abducto valgus or bunion is a deformity that occurs in three planes. Many previous surgical approaches address this deformity in one or two planes and hence why some bunion corrections do reoccur.  As a result of this research, many patents for new surgical techniques for management of bunions were developed. Dr Naraghi can explain and discuss the best surgical approach for correction of your bunions.  Dr Naraghi will also take into consideration any shoe limitation or aesthetic concerns you may have.

Reza will also help you decide which procedure will be most effective for your individual condition after evaluating your medical history and x-ray images.

Bunion surgery has come a long way and most people are able to walk on their feet immediately after surgery with no need for crutches or casts.  Recovery time and pain from bunion surgery depends on the individual patient and the complexity of the procedure, however most patients report minimal pain, are back to wearing normal shoes and return to their usual activities within 4 weeks.

Before and after Bunion Surgery example #1:

Bunion-surgery-1-300x194 Bunion / Hallux Valgus

Before and after Bunion Surgery example #2:

Before:

Bunion-surgery-2-e1582526790983-300x173 Bunion / Hallux ValgusBunion-surgery-4-e1570756348949-300x275 Bunion / Hallux Valgus

After:

Bunion-surgery-3-e1582526677571-300x254 Bunion / Hallux ValgusBunion-surgery-5-e1570756383453-203x300 Bunion / Hallux Valgus

Before and after Bunion Surgery example #3:

Bunion-before-e1593135271573 Bunion / Hallux ValgusBunion-after-e1593138382552 Bunion / Hallux Valgus

  • Winograd procedure- This procedure will be done in hospital setting under local and or general anaesthesia and it is reserved upon failure of the phenolization or if there is significant amount of skin overlapping the nail with soft tissue growth. This procedure involves removing a portion of the skin along with the nail down to the level of the bone. Sutures (stitches) will be applied to close the surgical site. The procedure takes about 10-15 minutes to be performed and your foot will be bandaged. You will be seen within first 5 days and then the sutures will be removed in 10-14 days. Currently this procedure can only be performed by Reza Naraghi (podiatric surgeon).  He will prescribe appropriate pain medication for your post-operative pain management. You will be in open sandal and or post op shoe for 2 weeks. This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a Winograd then please click here.
  • Zadik Procedure- This procedure is used with permanent total nail removal is desired. The indications for the procedure are significant ingrowing nail on both borders, thickened and painful nails and bony growth under the nailbed. This procedure can be done under local with sedation and or under general anaesthesia at a hospital and or day surgery centre. Sutures will be applied and will be removed 14 days post surgery. You can not get your foot wet and your foot will be in a sterile bandage for 2-3 weeks. You may need pain medication post surgery. On average it will take six weeks for your nail bed area to heal. Following that you can wear most close shoes.

Matrixectomy with phenolization- This procedure involves removing the nail partially or totally and ablating (destroying) the root using a weak acid called phenol. This will cause permanent ablation of the root of the offending nail and prevent ingrown nail recurrence. This procedure is successful 95% of the time. The procedure takes about 10-15 minutes and can be performed in our rooms using local anaesthesia with or without sedation. Post operatively you will be required to soak your toe and apply a daily dressing. Wearing open toe shoes for at least 3-4 days is recommended. You maybe required to take oral antibiotics. Most patients do not require pain medication following the procedure, and if needed Panadol is sufficient for pain management. You can go back to regular shoes after one week.  This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a partial nail matrixectomy with phenolisation then please click here.