Hallux valgus is the medical term for a bunion deformity involving the large big toe joint. In the simplest terms, a bunion is a partial dislocation of the joint at the base of the big toe. In the most advanced cases, it may even be a complete dislocation. As the big toe progressively dislocates toward the smaller toes, the head of the 1st metatarsal becomes more prominent; eventually, it can become painful. Despite what a bunion looks like, it is not an abnormal growth of bone or a tumor. The gradual dislocation of the joint causes abnormal function, and as the big toe goes in one direction, the first metatarsal head goes in the opposite direction and becomes prominent. Any joint in the body that is partially or completely dislocated cannot function normally until it is corrected.
As this joint progressively moves out of place, it causes increased pain, local swelling, and redness. (The redness is irritation from ill-fitting shoes.) There also may be an associated “burning” sensation due to the fact that your shoes push one of the nerves in the area against the prominent bone.
Bunion deformities are quite common in certain family groups, and therefore heredity can play a significant role in the development of this deformity. Abnormal mechanical function of the foot is also a major cause in the development of bunion deformities. A small percentage of individuals are actually born with bunion deformities. Statistically, more women than men have symptomatic bunion deformities.
As a bunion deformity progresses, the big toe will eventually position itself beneath the 2nd and 3rd toes. This will result in hammertoe deformities of these digits. In some more advanced cases, a bursal sack (fluid filled cyst) will develop between the skin and the joint. This is the body’s attempt to cushion the area, but it actually results in more pain. To avoid this, we recommend that patients get their bunions treated as soon as they begin to form.
Clearly in our modern society, high-heeled shoes, pointed shoes, and shoes that are too short or narrow will severely aggravate a bunion deformity. Shoes, however, do not cause bunion deformities. They simply aggravate deformities that are developing or already exist.
Bunions are a complex deformity. When this joint is not functioning normally then it will have a direct negative effect on the function of the remainder of the foot and ankle over time. Appropriate history and physical examination, bio-mechanical evaluation, and x-ray evaluation are necessary to make an accurate diagnosis, and to be able to recommend an appropriate treatment plan to the patient.
Conservatively, shoe modifications, foot padding, anti-inflammatory medication, orthoses, and occasionally alternative pain-relieving treatment may be recommended to a patient in an attempt to diminish or eliminate their painful symptoms. Splints or digital wedges will not be effective in permanently realigning the joint. Conservative treatments will not change the structural position of the joint.
Your Weil Foot & Ankle podiatrist may discuss and recommend surgical treatment. There are dozens of surgical procedures which have been developed over the past 150 years to treat bunion deformities. Appropriate surgical treatment of a bunion is based on proper evaluation and a determination of whether your deformity is positional or structural.
The surgeons at the Weil Foot & Ankle Institute have pioneered a bunion surgery called the “Scarf Procedure” that allows both of your feet to be corrected at the same time while also allowing you to return to athletic shoes 7-10 days after surgery.
As a general rule, bunion surgical procedures are performed on an outpatient basis in approved surgical centers or in a hospital. For many patients, we are able to surgically treat other deformities, such as hammertoes, corns, or calluses, at the same time that a bunion deformity is being surgically treated.
Following surgery, the foot is bandaged and a post operative shoe is worn for one week. Athletic shoes may be worn after the first week. Weight-bearing exercise and prolonged standing are restricted for the first 6-8 weeks. A home exercise program is important for regaining your strength and flexibility. You can steadily resume your normal activity and wear more fashionable shoes after healing is complete.
For additional information or to schedule an appointment, please contact us at (847)390-7666. Call Weil Foot & Ankle Institute for 5-star bunion treatment in Aurora, Chicago, Des Plaines, Glenview, Highland Park, Lake Forest, Libertyville, Oak Lawn, Oak Park, and Roselle, IL!
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