Do Bunions Need Surgery

posted on 04 Jun 2015 21:35 by ambitiousfuton434
Overview
Bunions Callous The common bunion is a localized area of enlargement of the inner portion of the joint at the base of the big toe. The enlargement actually represents additional bone formation, often in combination with a misalignment of the big toe. The misalignment causes the big toe to move outward (medically termed hallux valgus deformity). The normal position of the big toe (straight forward) becomes outward directed toward the smaller toes. The enlarged joint at the base of the big toe (the first metatarsophalangeal joint, or MTP joint) can become inflamed with redness, tenderness, and pain. A small fluid-filled sac (bursa) adjacent to the joint can also become inflamed (bursitis), leading to additional swelling, redness, and pain. A less common bunion is located at the joint at the base of the smallest (fifth) toe. This bunion is sometimes referred to as a tailor's bunion.

Causes
Bunions can be caused by the following factors. Hereditary (especially via the female line). Rolling in (pronation) of the feet. Walking with turned out feet. Weakness of muscles controlling the big toe. Weakness of intrinsic muscles of the feet. Leaning on the big toe in a tendu, especially to second or derri?re. Reduced mobility of the big toe when on demi-pointe. Restricted pointe range.

Symptoms
A bony bump along the edge of the foot, at the base of the big toe (adjacent to the ball of the foot) Redness and some swelling at or near the big toe joint. Deep dull pain in the big toe joint. Dull achy pain in the big toe joint after walking or a sharp pain while walking. The big toe is overlapping the second toe, resulting in redness, calluses, or other irritations such as corns.

Diagnosis
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
Sometimes observation of the bunion is all that?s needed. To reduce the chance of damage to the joint, periodic evaluation and x-rays by your surgeon are advised. In many other cases, however, some type of treatment is needed. Early treatments are aimed at easing the pain of bunions, but they won?t reverse the deformity itself. These include changes in shoewear. Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels which may aggravate the condition. Padding. Pads placed over the area of the bunion can help minimize pain. These can be obtained from your surgeon or purchased at a drug store. Activity modifications. Avoid activity that causes bunion pain, including standing for long periods of time. Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. Icing. Applying an ice pack several times a day helps reduce inflammation and pain. Injection therapy. Although rarely used in bunion treatment, injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located around a joint) sometimes seen with bunions. Orthotic devices. In some cases, custom orthotic devices may be provided by the foot and ankle surgeon. Bunion Pain

Surgical Treatment
Surgery can be a very successful treatment for bunions and could be considered if you are having pain that is affecting your function on a regular basis, for instance, pain during sports or wearing work shoes. It is important, however, that you are seen by a consultant orthopaedic foot and ankle surgeon who has undergone specialist training with a foot and ankle fellowship. There are many different surgical techniques and it is important that your surgeon is expert in several of these so that you have the one that is best for your unique deformity. Bunion removal is usually done under general anesthesia. This means you will be asleep throughout the procedure. The operation can be performed as a day-case, but an overnight stay in hospital is sometimes required. Your surgeon will explain the benefits and risks of having bunion surgery, and will also discuss the alternatives treatments.

Prevention
If the diagnosis is made early on, such as in preadolescence, bunion development can be slowed and in some cases arrested with the proper supportive shoe gear and custom functional shoe inserts (orthotics). Avoidance of certain athletic activities with improper shoe fit and toe pressure can prevent the symptoms that occur with bunions.
Tags: bunions