Bunions rarely develop from growths of bone, but the deformities occur when normal bones move out of position. The big toe falls to the side of the foot while the bone it is connected to in the foot falls the other way. As a result, the bones move out of alignment. Bunions can occur on either side of the front part of the foot but are most often seen at the base of the big toe. The medical term for bunions is Hallux valgus. Allowed to progress, the condition will develop to the point of a partial dislocation.
As the large toe bends towards the little toe the poor position of the joint will lead to the development of arthritis. Originally noted by the drifting of the large toe to the outside over time a large bump can be seen at the base of the great toe. The increased width of the foot and pressure from the developing bump will cause pain and occasional burning when wearing shoes as well as causing improper foot function leading to other painful conditions.
Bunions can form for several reasons. Some people are born with them but most develop over time due to improper shoe gear, loose ligaments, or changes in the shape of the joint over time. Heredity has been shown to play the major role in bunion formation, with certain families having multiple members with bunions. Statistically, women are more likely than men to have painful bunions predominantly from the unyielding style of shoes seen today. Abnormal mechanical function of the foot can also play a role in the development of bunions.
As a bunion increases in size, the big toe will lean and position itself beneath the second and third toes pushing them up and causing a hammertoe deformity. There are times where a fluid-filled cyst, or bursal sack, will grow between the skin and the joint overlying the bump which increases pain and burning. An uneven distribution of pressure and resultant pain and possibly callous formation occurs to the ball of the foot with the instability caused by a bunion. The best way to avoid pain is to have your bunion treated as soon as possible.
Conservative care has a place in bunion treatment. If you have a bunion, steer clear of shoes that are high-heeled, have pointed toes, or are too small for your feet, as they will cause irritation and increased pain of your bunion deformity. Conservative Bunion treatment varies and consists of orthotic shoe inserts, foot pads, anti-inflammatory medication, and other pain-relieving treatment methods. Many podiatrists use a combination of these methods to relieve or diminish foot pain. Alternative methods, like splints or digital wedges, have not proven to be effective in correcting a bunion deformity, and none of the above methods will provide a structural reposition of the toe joint.
For many, changes in shoes are simply not enough to provide relief. At times like this a surgical correction is the answer. In order to accurately and fully diagnose a bunion deformity, a Podiatrist will look at your medical history, perform a complete physical examination, a bio-mechanical evaluation and use x-ray technology. Once complete, the doctor will have a full understanding of the extent of that bunion condition and be able to recommend a treatment for your condition.
Should our Podiatrists at Weil Foot & Ankle find that surgical treatment is the best course of action we have the latest and best options for you. Many surgical procedures that have been developed over the last 150 years to remove bunions and restore the toe joint to it’s original position.
Weil Foot & Ankle Institute proudly offers two proprietary procedures available for treating bunions. They are:
Lapiplasty – which addresses the instability by fusing a joint in the midfoot
Scarfplasty – which realigns the bones and allows for a shorter recovery time than most bunion procedures. Both feet can be treated in a single surgery and patients can bear weight almost immediately after surgery.
The Scarfplasty was developed by the surgeons at the Weil Foot & Ankle Institute. Utilized worldwide the “Scarf Procedure,” allows simultaneous correction of both feet and the ability to return to wearing regular shoes 7-10 days after surgery.
Surgical procedures for bunion removal are usually performed on an outpatient basis in either a surgical center or hospital. In many cases, other associated conditions such as hammertoes, corns, or calluses, at the same time.
After your surgical procedure, the foot is bandaged, and a special post-operative shoe must be worn for one week. Beyond the first week, athletic shoes may be worn and activity is gradually increased but weight-bearing exercise and prolonged standing are not recommended for 6-8 weeks. Physical therapy is used along with a program of home exercises to speed and improve the healing. Once healing is complete, you can return to normal activity and wear regular shoes.
View research and publications from Weil Foot & Ankle Institute on bunion surgery:
- Retrospective Comparison of Patients Undergoing Formal Physical Therapy Versus No Physical Therapy Following Bunion Correction
- Scarf Osteotomy for the Correction of Adolescent Hallux Valgus
(Foot & Ankle Specialist, February 2010)
- Unilateral Versus Bilateral First Ray Surgery
(Foot & Ankle Specialist, June 2009)
- Predicting articular erosion in hallux valgus: clinical, radiographic, and intraoperative analysis
(Journal of Foot and Ankle Surgery, January/February 2005)
- Mastering The Scarf Bunionectomy
(Podiatry Today, January 2003)
- ACFAS Universal Foot and Ankle Scoring System: First Metatarsophalangeal Joint and First Ray (module 1)
(Journal of Foot and Ankle Surgery, January/February 2002)
- Scarf osteotomy for correction of hallux valgus. Historical perspective, surgical technique, and results
(Foot and Ankle Clinics, September 2000)
- Bipartite tibial sesamoid and hallux abducto valgus deformity: a previously unreported correlation
(Journal of Foot Surgery, March/April 1992)
- Hallux abductus interphalangeus. Etiology, x-ray evaluation and treatment
(Journal of the American Podiatric Medical Association, February 1992)
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