A bunion, also called ‘hallux valgus’, is a common foot deformity. Bunions can occur in both children and in adults. The cause of the deformity varies. Contributing factors include genetics, tight shoes, and other structural abnormalities of the foot. The most common symptom from a bunion is pain at the inner (medial) side of big toe. Related symptoms may include pain underneath the other toes, the development of hammertoes, and difficulty finding shoes that don’t cause pain. Some patients are also bothered by the appearance of the foot.
It is very important to understand that a bunion is not simply an extra bone that can be shaved off, but rather an angular deformity between the bones of the big toe and the 1st metatarsal bone at the base of the big toe. As the deformity progresses, the inner side of the great toe becomes prominent. This is the prominence that people sometimes mistakenly think is a bone spur that can be shaved off.
A thorough evaluation of a bunion typically includes x-rays and assessment of the specifics of the deformity and symptoms. The x-rays are used to assess the alignment of the various bones and joints as well as identify arthritis, if present.
Treatment often begins with modification of shoewear and sometimes the use of a brace. If these efforts fail, surgery may be necessary to properly realign the bones of the foot. Surgery for bunions can be complex, and there are many different procedures used, depending on such factors as the bone quality and the degree of the deformity. Some bunions even require the use of an “osteotomy.” This is a surgical procedure in which a bone is cut, re-aligned, and then held together with screws or a plate.
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