Bunion surgery in Turkey

Bunion surgery corrects hallux valgus, the deformity in which the big toe drifts towards the second toe and the joint at its base pushes out to form the bump. The surgeon cuts the bone, moves it back into alignment and holds it with screws or a plate. Shaving the bump alone does not correct the angle, and the deformity returns.

The reason to have it is pain, not appearance. Surgeons operate when a bunion hurts in normal shoes, makes walking difficult or has begun to push the smaller toes out of position. A bunion that looks unattractive but does not hurt is usually better left alone, and any clinic that skips that distinction is selling rather than assessing.

Bunion surgery is an osteotomy: a controlled cut through the first metatarsal, and sometimes through the toe bone as well, so that the bones can be repositioned into alignment and fixed there while they heal. The soft tissues around the joint are released on the tight side and tightened on the loose side to hold the correction.

Where the deformity comes from the joint at the base of the metatarsal rather than its head, the surgeon may fuse that joint instead, which is a larger operation with a longer recovery but a lower chance of the deformity coming back. Where the joint itself is badly arthritic, fusing the big toe joint may be the better answer than realigning it.

1. 1

   Weight-bearing X-rays

   Taken standing, because the angles change under load. This is what decides which operation you need, and a plan made without them is a guess.
2. 2

   Anaesthetic

   Often an ankle block with sedation, sometimes spinal or general. Many patients are awake and go home the same day.
3. 3

   Realigning the bone

   The metatarsal is cut and shifted into position, the toe bone is corrected where needed, and the bump is trimmed once the angle is right.
4. 4

   Fixation

   Screws, and sometimes a plate, hold the corrected position while the bone unites. They usually stay in permanently unless they irritate.
5. 5

   Soft tissue balancing

   Tight structures on the outer side are released and loose ones on the inner side are tightened, so the toe is held straight rather than drifting back.
6. 6

   Dressings and shoe

   A bandage that holds the toe in position and a stiff-soled post-operative shoe or boot. How you are allowed to walk depends on what was done.

• The flight is the main planning problem. Foot surgery plus a long flight raises the clot risk, and a swollen foot in a cabin is genuinely uncomfortable. Ask what the surgeon wants you to do and when they will clear you to fly.
• Bring or arrange the X-rays. Standing X-rays are the basis of the plan. Confirm whether they are taken on arrival and whether that is included in the quote.
• Ask about getting around. Which airport assistance, how many stairs at the hotel, and whether crutches or a knee scooter are provided.
• Ask who removes the stitches. And who reviews the wound if it is not healing when you are already home.
• Plan for both feet carefully. Some surgeons correct both at once, others stage them. Doing both means you cannot use the other foot to compensate, which changes the whole trip.

• Ask how much of their practice is foot and ankle. Bunion correction is a subspecialty. General orthopaedics is not the same thing.
• Ask which techniques they perform. Someone who does open, minimally invasive and fusion can pick. Someone who does one will fit you to it.
• Ask to see your own X-ray measurements. And to have the plan explained on them. This is the clearest sign that you are being assessed rather than sold to.
• Ask what their recurrence rate is and what they do about it. Not for a number to quote back, but to hear whether they track it at all.
• Ask when you may fly. And get the answer before you buy the ticket.