What Is Hallux Abducto Valgus?
Bunion is a prominence of the medial portion of the head of the 1st metatarsal bone. The cause is often variations in position of the 1st metatarsal bone or great toe, such as lateral angulation of the great toe (hallux valgus). Secondary osteoarthritis and spur formation are common. Symptoms may include pain and redness, bursitis medial to the joint, and mild synovitis. Diagnosis is usually clinical. Treatment is usually a shoe with a wide toe box, protective pads, and orthotics. For bursitis or synovitis, corticosteroid injection may be helpful.
Bunions most commonly affect women. Some studies report that bunions occur nearly 10 times more frequently in women. It has been suggested that tight-fitting shoes, especially high-heel and narrow-toed shoes, might increase the risk for bunion formation. Bunions are reported to be more prevalent in people who wear shoes than in barefoot people. While the precise causes are not known, there also seems to be inherited (genetic) factors that predispose to the development of bunions, especially when they occur in younger individuals. Other risk factors for the development of bunions include abnormal formation of the bones of the foot at birth (congenital), nerve conditions that affect the foot, rheumatoid arthritis, and injury to the foot. Bunions are common in ballet dancers.
SymptomsMany people do not experience symptoms in the early stages of bunion formation. Symptoms are often most noticeable when the bunion gets worse and with certain types of footwear. These include shoes that crowd the toes and/or high-heeled shoes. When symptoms do occur, they may include physical discomfort or pain. A burning feeling. Redness and swelling. Possible numbness. Difficulty walking.
The doctor considers a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot, including joint and foot function, is assessed during the examination. Radiographs (X-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes when taken in a standing position.
Non Surgical Treatment
Getting rid of a Bunion is almost impossible without surgery. Foot and toe exercises can help. Foam pads can reduce the pressure on the joint. Ice packs and anti-inflammatory medication can help reduce swelling. The progress of a Bunion can be slowed or even halted, especially if it is caused by ill-fitting footwear. Of course the best course of action is to not wear pointy-toed high-heel shoes to begin with. But if you have worn improper footwear and now want to stop the progress of Bunions.
If your bunion is symptomatic and causing you persisting and troublesome symptoms then surgery should be considered. There is no correct amount of pain or inconvenience which a bunion may cause which warrants surgery. Symptoms which a bunion causes are generally subjective, and what is a problem in one person?s view will not be a problem in another's. For bunion surgery to be successful (correcting the deformity and losing the symptoms) the mechanical factors driving the deformity should be overcome. Bunion surgery should replace the 1st metatarsal closer to the 2nd thus reducing the width of the foot, and also realigning the tendons and reducing their deforming forces. These principals of bunion surgery are well demonstrated by the following x-rays which shows how a Scarf osteotomy has achieved this aim.
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