Q1: What can I do to help prevent my bunion from becoming worse?
A:

a.    Wear as little high heels and pointed shoes as possible.

b.    Use bunion-specific foot orthoses for best protection.

c.    Try silicon toe spreader or night splint but their effectiveness is not known.

d.    Physiotherapist instructed foot and toe exercises.

Q2: If I have a family history of bunion condition, what is the chance of me developing it?

A: Genes play a strong role in majority bunion patients. You may have inherited bunion genes but their effects are random and there is no statistics yet of their expression among family members. Female hormones (estrogen) can also compound the risk greatly and tilt the gender-balance to 9 times more common among female than male.

Reference information: www.bunioncenter.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.

Who gets a bunion deformity and the High Heel Myth? (Part 2)

Female hormone can possibly be the most important causative factor in bunion development is because bunion/ hallux valgus is a soft tissue problem of ligament loosening and female hormones is responsible for looser female joints than male's and loosening of pelvic ring for easier delivering of babies. Interestingly, some women did notice their bunion deformity had become worse during and soon after their pregnancies.

In summary, bunion is mainly a female condition relating to their female hormone and often compounded by heredity. Although high-heel shoes are not the main cause of ligament failure in bunion feet, they can probably precipitate earlier onset and accelerate progression of a bunion-prone foot due to genetic factor. Avoiding high heels may help prevent unnecessary aggravation but not necessarily its progressive nature. If a woman has no family history of bunion deformity, there is still certain risk in wearing high heels for many years.

Reference information: www.bunioncenter.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.

Who gets a bunion deformity and the High Heel Myth? (Part 1)

Contrary to popular belief, high-heel shoes are actually not the main cause of ligament failure in bunion feet. Studies have indeed shown that more than 90% of bunion sufferers are female and that societies changing from barefoot to wearing ordinary shoes (not even high-heels) increased in their incidence of bunion condition.

 However, there have been no subsequent studies to show how much high-heel shoes make feet more susceptible to bunion formation than the original findings by ordinary shoes. The reason for female being more susceptible to bunion development is due actually to their female hormones (estrogen) which tend to loosen up ligaments, including the ones supporting the displaced bones in bunion feet. Genes plays also a much more important role than high-heel shoes. 

Studies have shown more than 80% of bunion sufferers have positive family history and most of them never wore much high heels at all. A small proportion (<5%) of bunion patients can only blame on their high-heel shoes for they have no family history of bunions. One study showed that positive family history is probably 25 times more important as a cause of bunions than high-heel shoes

Total 1056 surveyed	395 (36.5%) had bunions	High heels (+)	High heels  (-)
395 (36.5%) had bunions	100%	17%	83%
Family History (+)	88%	14%	74%
Family History (-)	12%	3%	9%
Survey results initiated by Center for Dr. Wu's bunion surgery with the co-operation of Hong Kong Baptist University

Reference information: www.bunioncenter.com

It is not intended as medical advice to any specific person. 
If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.

When can I return to extreme usage of my feet?
All restrictions on activities and shoes are removed 6 months after surgery. Patients can try to return to any sports, jogging, dancing and wearing hi-heels as desired.

What is the long term recurrence rate?
To our knowledge, there has been no recurrence of loosening and displacement of first metatarsal bone after first 6 months when the syndesmosis bridge has become probably more than 100% strong and safe for all type of activities and shoes.

Similarly, there has been little change in the big toe alignment.


The million-dollar question of "If syndesmosis procedure is so good, why no other surgeons have jumped into the wagon?" The answer is it takes time for other surgeons to accept it until it can also be reproduced by independent parties.

Dr. Wu reported his surgical technique and results in the Foot and Ankle International Journal in 2007 and hopefully it has caught attention of some surgeons. Certainly, its feasibility and results have not been proven otherwise.

Reference information: www.bunioncenter.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.

What restrictions do I need to observe?

What restrictions do I need to observe?
You need to wear protective footwear for walking and standing for the first 3 months. You should avoid excessive walking to no more than 3-6,000 steps a day.

Why do I need to restrict my walking initially?
This is to protect the internal stabilizing sutures before the ligament bridge (syndesmosis) is formed.


Do I need physiotherapy?
It is entirely optional and usually recommended for patients with stiffer big toe joints


When can I drive again?
Usually in one month's time when normal feeling and reaction return to the operating and operated foot which applies of course usually to the right foot.


When can I return to unlimited walking, such as hiking?
About 4 months after surgery.

Reference information: www.bunioncenter.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.

After bunion surgery is hospital stay necessary?

It is not absolutely necessary but most people prefer staying overnight for their peace of mind and comfort.

How much surgical pain is there usually and for how long?
Obviously each individual case can be different to some extent, but most people have moderate pain for no longer than first 24 hours after surgery and it can usually be controlled by oral pain killers. Injection is not usually needed.


When will I be allowed and able to walk?
Walking is allowed and possible anytime after surgery, although there may be slightly more pain for the first few days.


Do I need crutches?
They are optional but most people find them useful for their security and comfort for the first week after surgery.


When can I wet my feet for bathing?
About 10 days when the wound is healed.

Reference information: www.bunioncenter.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.