Bunions are one of the most common conditions we treat everyday. Even though bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment.
A bunion (also referred to as hallux valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment—producing the bunion’s bump.
Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.
Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited but certain foot types that make a person prone to developing a bunion. This is were genetics plays a major factor. Although wearing shoes that crowd the toes will not actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may therefore appear sooner.
Symptoms, which occur at the site of the bunion, may include:
Pain or soreness, Inflammation and redness, A burning sensation, Possible numbness
Bunions are readily apparent—the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred.
Because bunions are progressive, they do not go away and will usually get worse over time. But not all cases are alike—some bunions progress more rapidly than others.
Sometimes observation of the bunion is all that is needed with some changes in shoe gear and custom orthotics. NSAIDS, ice and topical medication can help with the pain but expert it to be short term.
Surgery in our hands can be a divided into three procedures which are specifically chosen for the patient and not just because of the current fade or hardware.
1- Metatarsal osteotomies: These procedures are typically used for mild to moderate size bunions. The metatarsal is surgically moved to the corrected position and held by a couple screws. Sometimes the phalanx (akin) also requires an osteotomy to place the toe straighter This procedure is completed at a surgery center/ OR and is outpatient. Postop patient are required to wear a walking boot for 6 wks.
2- 1st Metatarsal -cuneiform arthrodesis (Lapidus): This bunion procedure is saved for moderate to severe bunions typically. It is preformed as a outpatient procedure in a surgery center/ OR. This bunion correction places the 1st metatarsal parallel and derotated to the 2nd metatarsal and held by screws or staples. Recovery is a little longer typically 8 weeks in a boot.
3- Minimally Invasive Bunion Correction ( MIS bunion )- this type of bunion correction is for mild -moderate bunions without any underlying osteoarthritis of the big toe joint. This procedure requires several small incisions to correct the bunion position. Specialized training is required to offer this type of correction; however, still requires 6-8 wks in a boot.
No matter what stage or type of bunion deformity you have we can offer you a selection of surgery that is suitable for you, your expectation and your recovery limitations. With over 13 years correcting bunions we can guide you to a successful outcome.