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Education Center

Education Center
Education is a vital part of keeping your feet healthy. When we know how to take care of our feet and keep them clean, we experience better foot health, catch problems earlier, and work to prevent serious complications.

Bunions

What Is a Bunion? A bunion is basically a shift of the big toe bones into an improper position, causing pain and loss of function. The deformity involves the big toe and the long bone behind the big toe (the first metatarsal). Over time, the first metatarsal will begin to move towards the other foot (medially) while the big toe will move out of joint towards the second toe (laterally). As the end of the first metatarsal bone begins to stick out, pressure will become increasingly applied from shoes and the ground. This constant pressing and friction will cause extra bone formation, leading to the trademark bump that is seen on the side of the foot. The big toe will continue to shift towards the second toe causing an unbalanced big toe joint. One long-term effect is arthritis, which can develop in the joint due to its incorrect positioning. A bunion deformity is always progressive; it will get worse with time.

What Causes a Bunion? Bunions are usually a genetic deformity. There is an imbalance of the muscles and the ligaments that are holding the first metatarsal in place. As this joint becomes weaker over time, the long metatarsal bone will begin to shift medially. The big toe is then put under stress and begins to shift laterally under the pressure of the joint and shoes. Certain shoes can help create and/or aggravate a bunion, such as high-heeled shoes or those with a tight and narrow toe box. Patients with a flat foot type (pronation) have a higher chance of having a bunion in the future.

What Are Bunion Symptoms? A bunion deformity does not always have to be associated with pain. Some patients have a very severe deformity and no pain, while others with a mild deformity have severe pain. Patients usually will have pain right over the bump due to continued irritation and bruising to the bone from shoe gear and the ground forces. As the deformity progresses, pain will then be noticed in the joint itself when the big toe is moving. The big toe is very important during the gait cycle for pushing off the ground. With this joint imbalance, there is a loss of the proper range of motion of the big toe joint, thus leading to an inefficient gait. Over time, arthritis will develop in the joint as cartilage is scraped away each time the joint moves. This pain can be experienced at different levels depending on the degree of deformity, the type of shoe gear worn, and activity level.

How Do You Diagnose a Bunion? A clinical examination of the foot is done first. It is very important that the structure and biomechanics of the patient’s entire foot be checked. It is also essential to test the stability of the joints around the bones involved and see if the big toe can be re-located easily back into the joint; this helps to identify the deformity’s severity. The doctor will also analyze the gait pattern of the patient and ask how much pain the patient is experiencing. X-ray evaluation allows for exact angle measurements to be taken with respect to the relationships between the bones, a necessary step in order to determine the degree of bone shift.

Hallux abductus angle measurement is used to measure the shift of the great toe towards the second toe for bunion correction decision making.

Intermetatarsal angle measurement is used to see the shift of the first metatarsal from the second metatarsal.

How Do You Treat a Bunion? Dr. Henson uses a specialized treatment plan maximized for patient recovery. Often, patients are able to walk on the treated foot the same day as their procedure. In addition, he uses an incision on the side of the foot as opposed to the top to minimize the appearance of scarring.