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Bunion – hallux valgus

  

A bunion is a bony deformity of the joint at the base of the big toe. The medical name is hallux valgus.


Prior approval from the Clinical Commissioning Group will be required before any treatment proceeds in secondary care.

Requests for the removal of symptomatic bunions will only be considered if specific criteria are met, as detailed below.

Age, gender, smoking, obesity and co-morbidity should not be barriers to referral. Patients with significant co-morbidities (systemic or local) should have treatment which optimises these before referral.

Referral to Secondary Care

Referral is based on the following criteria:

  • Deteriorating symptoms AND/OR
  • Failure of appropriate conservative measures after 3 months AND/OR
  • Persistent pain and disability, not responding to up to 12 weeks of non-surgical treatments AND
  • Patients must be prepared to undergo surgery

Prior approval from the Clinical Commissioning Group will be required before any treatment proceeds in secondary care.

Conservative measures

Conservative Measures are defined as:

  • Ice and elevation for pain and swelling AND
  • Optimum analgesia.
Non-surgical treatments

Non-surgical treatments are defined as:

  • Wearing wide cut or specially altered shoes with increased medial pocket to minimise deforming forces AND
  • Externally fitted devices to improve alignment and reduce irritation, e.g. orthoses and bunion pads AND
  • Stretching exercises to improve / maintain joint flexibility.
  • Patient MUST NOT be referred for surgery based on cosmetic reasons alone.
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