A bunion or hallux valgus is a structural deformity (enlargement) of the bones or tissue and the joint between your foot and big toe. In a bunion, your big toe points toward the second toe (angulation) causing a bump on the edge of your foot, at the joint of your big toe and is painful. The tissues surrounding the joint may be swollen and tender.
Causes of Bunions
Bunions are caused by a biomechanical abnormality, where certain tendons, ligaments, and supportive structures of the first metatarsal (the bone in the body of the foot just behind the big toe) are no longer functioning correctly. This biomechanical abnormality may be caused by a variety of conditions intrinsic to the structure of the foot such as flat feet, excessive ligamentous flexibility, abnormal bone structure, and certain neurological conditions.
Risk Factors of Bunions
- Bunions occur more commonly in women and sometimes run in families (are genetic).
- People born with abnormal bones in their feet are more likely to form a bunion.
- Wearing narrow-toed, high-heeled shoes may lead to a bunion.
- The condition may become painful as extra bone and a fluid-filled sac grow at the base of the big toe.
Symptoms of Bunions
- Irritated skin around the bunion
- Joint redness
- Pain over the joint, aggravated by pressure from shoes
- Possible shift of the big toe toward the other toes
Prevention of Bunions
- Take good care of feet.
- Wear wide-toed shoes instead of narrow, poor-fitting shoes that compress your toes.
Treatment of Bunions
To address the symptoms conservative methods can be used at first. Here are some of them:
- Try changing your shoe gear. Wear wide-toed shoes and avoid using narrow, poor-fitting high-heeled shoes. You can also try cutting a hole in a pair of old, comfortable shoes to wear around the house.
- Pads placed over the area of the bunion can help alleviate pain. It may help to wear felt or foam pads on the foot to protect the bunion, or devices to separate the first and second toes at night.
- Avoid activities like standing for prolonged periods that may cause bunion pain.
- Medications (ask your doctor for advice)
Orthotics are bunion cushions, splints, regulators while conservative measures include various footwear like gelled toe spacers, bunion / toes separators, bunion regulators, bunion splints, and bunion cushions.
Bunion removal surgery may be recommended when the bunion gets worse and other, less invasive treatments (such as switching to shoes with a wide toe box) do not work. The surgical removal of bunion is called Bunionectomy or Hallux valgus correction. Surgery corrects the deformity by realigning the toe removing the bony bump and restores normal, pain-free function.
There are over 100 different surgical techniques that have been described to treat this condition and other pathologies associated with the bunion. For instance, procedures may address some combination of:
- removing the abnormal bony enlargement of the first metatarsal
- realigning the first metatarsal bone relative to the adjacent metatarsal bone
- straightening the great toe relative to the first metatarsal and adjacent toes
- realigning the cartilagenous surfaces of the great toe joint
- addressing arthritic changes associated with the great toe joint
- repositioning the sesamoid bones beneath the first metatarsal bone
- shortening, lengthening, raising, or lowering the first metatarsal bone
- correcting any abnormal bowing or misalignment within the great toe.
The age, health, lifestyle, and activity level of the patient may also play a role in the choice of procedure.
Bunionectomy or Bunion Removal
Surgical removal of a bunion rarely requires a hospital stay. Bunion surgery can be performed under local, spinal, or general anesthetic. The surgeon will make a cut along the bones of the big toe into the foot and repair the deformed joint and bones. A pin or cast will be used to stabilize the bones.
Risks and Complications of Bunion Removal
- Numbness over the big toe
- Wound breakdown
- Recurrence of deformity
- Chronic foot pain
- Foot deformity
- Stiff foot
- Hallux varus (occurs with surgical over-correction, where the toe points away from the second toe)
Recovery and Care after Bunion Removal
The patient is advised to keep the foot propped up and protected from pressure, weight, and injury while it heals. A patient can expect a 6- to 8-week recovery period during which crutches are usually required for aid in mobility.
Outlook or Prognosis after Bunion Removal
The outlook depends on your age and activities, and the severity of the bunion. Most people recover completely from the surgery though teenagers may have more trouble treating a bunion than adults. Many adults do well by caring for the bunion when it first starts to develop, and wearing different shoes.
Low cost surgery abroad for Dupuytren's contracture
The cost of bunion removal surgery in Mexico, Costa Rica, Panama, India and several other countries is considerably lower (70% or less) than its cost in the United States. Healthbase has an extensive network of healthcare providers abroad that offer top quality bunion removal surgery including bunionectomy. The overseas healthcare providers are JCI-accredited and hence the quality of care rendered to inernational patients from the US, Canada, and other countries is on par with what you would expect to get in the United States. The podiatric surgeons performing bunion removal operation abroad in Mexico, Panama, Costa Rica, India, Singapore, Turkey, etc. are educated and / or trained in the United States and Europe and are as qualified as their counterparts in US and Europe. For a FREE consultation with an English-speaking foot and ankle surgeon overseas on the Healthbase network for treatment of bunion, contact us.
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