Mr Sam Singh, one of the highest volume foot and ankle surgeons in London, talks through the gold standard of treatment and which bunion surgery is best.

How do you get bunion surgery right first time?

To treat a bunion properly, one has to understand that the main deformity is that the bones have changed location, and that is what has caused the problem. So, all operations involve realigning the bone architecture of the foot. The most widely performed operation, at least in the UK, which we call the scarf osteotomy (sometimes combined with an akin osteotomy) - to break and realign the metatarsal - is the gold standard against which other operations are judged because we've done very large numbers of them worldwide.

Is keyhole bunion correction surgery successful?

There is online for example, quite a lot of presence and people talking about keyhole bunion surgery. Now, I have a very busy practice in bunion correction and it’s something I’ve also toyed with in the past. But one of the problems is, the re-operation rates are high. And if you’re having your bunion corrected, one of the things you don’t want to do, is to have any form of further surgical procedure. That’s very important if you’re going to give the patient a good outcome.

Are screws in the bone necessary in bunion surgery?

People get very worried when they come to see me. They’re worried that we’re going to put screws in them, and people think that when you screw something together it means it’s never going to move again. So, the screw is not to stop the joint moving - which would be a fusion operation of the big toe - instead, what you’re doing is allowing movement but your screw is just holding the bones in the right place while the bones mend. And we know bones typically mend in six weeks.

Now the screw is just holding the bone, it's not holding the bone together for the rest of your life, it's just holding it while it mends - like scaffolding on a building. Now, when you finish your building project, you remove the scaffolding. In the foot, because we use screws that can't be felt and are buried, we just leave them in place.

 This is performed in order to correct a deformity of the hallux valgus. This is located at the base of the big toe joint which protrudes. Surgery involves breaking, realigning and fixing the bones of the first metatarsal and phalanx.

 performs hundreds of bunion correction surgeries a year. Alongside this high volume bunion practice, he performs a variety of procedures in the foot and ankle for the treatment of conditions such as: Morton's neuroma, achilles disorders, plantar fasciitis, ankle sports injuries, mallet and hammertoes.

Please contact our concierge team on 020 8064 0875 if you need other treatments.

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