Do Bunions Call For Surgery

Overview
Bunions
A bunion is a deformity of the big toe. A bunion is a toe that points at a sideways angle towards your second toe. There is also a characteristic bump on the inner side of the foot. As the bunion becomes more prominent, bunion pain can develop. The medical term for a foot bunion is hallux valgus.

Causes
Bunions are the byproduct of unnatural forces and motion being applied to the joints and tendons of your foot over a prolonged period of time. They can also be caused by traumas to the foot as well as congenital deformities. Occupations or athletic activities that place abnormal stress on your feet can also lead to the formation of bunions. Bunions have a tendency to run in families, but it?s not the bunion itself that is hereditary. It?s the the foot type which *causes* the bunion that is hereditary. Also, wearing shoes such as high heels that do not distribute your body weight evenly can lead to bunions, which explains why so many women suffer from bunions.
SymptomsThe pain from a bunion is felt around the MTP joint of the big toe. People with bunions often complain of pain when they when they stand or walk for long periods of time. High heeled shoes or shoes with a small toe area can make bunions feel and look worse. As a result of the deformity the big toe can lose some of its range of motion or become stiff. Sometimes both feet are affected.

Diagnosis
Orthopaedic surgeons diagnose bunions on the basis of physical examination and weight bearing x-rays. Two angles are assessed, the intermetatarsal angle, that is between the first and second metatarsals (the bones that lead up to the base of the toes). If this angle exceeds 9? (the angle found in the healthy foot) it is abnormal and referred to as metatarsus primus varus. the hallux valgus angle, that is, the angle of the big toe as it drifts toward the small toe. An angle that exceeds 15? is considered to be a sign of pathology.

Non Surgical Treatment
Custom orthoses or over-the-counter insoles to aid big toe joint function, help control over-pronation and maintain proper alignment of the bones in the feet. Properly sized, supportive footwear that are torsionally stable (can?t be folded or twisted easily) and that feature a good ?rocker profile? (curved from the ball to tips of the toes) help to reduce stress on the joint when walking. Footwear modifications to expand the area of the shoe surrounding the bunion to relieve pressure. Physical therapy modalities include rest, icing and massage. Injections, surgery and other treatment options, please consult your medical doctor for information and/or referral to a podiatrist or other foot and ankle specialist.
Bunions

Surgical Treatment
As mentioned above, with mild cases, the bone is cut close to the big toe joint and shifted over into a correct position. The cut bone is held in placed with one or two surgical screws. With this procedure, just the top of the bone is moved over and the bottom of the bone remains in the same place. This technique is called the Austin bunionectomy and refers to type of bone cut that will be made by the Surgeon. There is, however, a limit on how far one can move the bone over with this technique. Its is generally thought that the cut bone should only be moved over a distance equal to half the width of the bone. In somes the bone may be moved over further.

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