In August 2010, Mrs Tina Schlosz from Hornchurch, Essex came to Spire Hartswood Hospital in Brentwood after years of suffering from bunions on both of her feet.
Tina explains: “I developed bunions when I was quite young and actually had my first operation on them at the age of 13. This didn’t really work and my bunions got progressively worse over a number of years.”
Tina found that her bunions were becoming very painful to walk on and shoes were not fitting her feet properly. Wearing shoes were making the problem worse and it became a cycle of pain.
Bunion treatment
Tina decided that she had suffered for long enough and went to see her GP for advice. “My GP was very good and advised me to see an orthopaedic surgeon. I decided to use my private medical insurance so that I could be seen and treated quickly. I called Spire Hartswood Hospital in Brentwood because I knew it was a local private hospital with a good reputation and I chose my own consultant.”
Tina opted to have a consultation with consultant orthopaedic surgeon Mr Krishna Vemulapalli who specialises in foot and ankle surgery at Spire Hartswood Hospital.
“My consultation took place at the end of August / beginning September and went really well. The first thing Mr Vemulapalli said to me was that I wasn’t walking straight. He had seen me walk in and could tell that I was subconsciously avoiding putting my weight on my big toes which were painful to walk on.
“Mr Vemulapalli examined my feet and bunions and gave me three options of treatment. I could choose to have only my bunions removed, have my bunions and a few of my toes operated on or lastly my bunions and all of my toes operated on. Although it was my choice he made the suggestion of my bunions and some of my toes to try and match my expectations.”
Tina booked in to have her surgery for January so she would not be recovering through Christmas. The surgery took around three hours and Tina stayed overnight.
Recovery after bunion surgery
Tina saw the physiotherapists the day after surgery and was issued with special soft shoes and crutches. Later that day Tina managed to walk using the crutches and went home.
Tina tells us more: “I have to be truthful and say that it was fairly uncomfortable and I could not walk on my feet for two weeks. My husband and children had to help me to move around, I was in plaster for two weeks and also used crutches, but I was very dependent on my family for help.
“After two weeks I went back to see Mr Vemulapalli at the hospital where they removed the plaster and changed my dressings. I was also then told to wear my special soft shoes that had a slight heel in them.”
Tina was surprised by the look of her feet when the dressings were removed: “They looked awful to begin with. Mr Vemulapalli had shaved off my bunions and broken and re-set my big toe and second and third toes on both of my feet. As a result there was a huge amount of swelling but not so much bruising. They were very uncomfortable to walk on, even with the shoes.”
Tina had been advised by Mr Vemulapalli prior to the surgery that recovery would take several months but some of the results had already began to show. “I had straight feet. It was really odd to look at as I have never had straight facing feet before. Also my hips had begun to ache because I was walking properly for the first time in years and moving in a way I hadn’t done previously.
“It is seven months later and most of the swelling has gone down but the toes are still tender and I still cannot get most of my old shoes on. I have had to learn to walk again in some ways as your big toes play a huge part in balance.
"However, I feel I have done the right thing. The bunions had been so painful and now I can walk without pain. I had suffered for 25 years and for the first time, I can walk about and not have to stop and rest my feet. I even went to a shopping centre and walked solidly for a few hours which I could not have done before. I am looking forward to getting my party shoes on which I hope I will be able to do in the not too distant future.”
The surgeon's view - Mr Krishna Vemulapalli
“Bunions can be hereditary; if a member of a family has bunions it isn’t uncommon to find that other family members develop them too. Bunions can also be caused by inappropriate footwear such as narrow toed and high heeled shoes. Wearing these shoes occasionally is ok, but wearing them often can contribute to developing bunions in the future."
Tina’s treatment:
Mr Vemulapalli says: "Tina’s case was complex because of her first operation 36 years ago to treat bunions. When her first operation was performed the surgeon had shortened her big toes. Scans of her feet showed that the difference in length between her second and big toes were significant on both feet. On her left foot her big toe was over 7mm shorter than her second toe and on her right the difference was 11mm.
"I suggested that I re-set her first, second and third toes to treat her bunions and to correct her other toes' alignment which would allow her to walk straight (as her walking had also been affected by her previous operation)."
Modern approach to treating bunions:
"Technology and approach has moved on and I offer SCARF osteotomy (as used on Tina) for bunion correction which allows me to move the first metatarsal (the first long bone in the foot), stabilise it and thus correct the bunion without losing toe length and keeping alignment. This is an effective operation for treating bunions and patients are generally very pleased with the results.”