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Bunion Deformity

Bunions are a common foot condition.  The vast majority of bunions occur in females, but they may develop in males, as well.  Most bunions result from pressure caused by shoes that are too small, narrow, pointed, or have a high heel. Genetics can also play a role where often parents, grandparents, siblings have suffered from the same problem.   Arthritis, particularly osteoarthritis, and polio can contribute to bunion formation.
Contrary to what most people believe, bunions are not just a “bump” growing on the inside of your big toe. It is actually an angular deformity of the foot that develops from an imbalance of the muscles and ligaments around the big toe  The big toe may lean toward or move underneath the second toe.  The second toe may move out of alignment and overlap the third toe.  Long term irritation causes the base of the big toe to enlarge and a fluid-filled sac may form.  This creates a large bump on the side of the foot at the joint. A bunion can be large, red, swollen, and painful.  The skin on the bottom of your foot may thicken and form a painful callus.  It may hurt to bend your toe, walk, or wear shoes.
A bunion causes your foot to look different.  Your big toe may lean towards your second toe.  The first few toes on your foot may lean and overlap.
Simply changing shoes may treat some bunions.  It is helpful to wear wide-toed shoes with low heels.  Good foot care and felt or foam pads worn between the toes or on the foot may help protect the area and prevent further discomfort. 

Custom-made shoe inserts can help position the toe and relieve pain.If non-surgical treatments fail, surgery may be necessary to restore normal alignment, pain-free movement and function.  Bunion surgery is used to realign the bones, joints, tendons, ligaments, and nerves.  The toes are placed in their correct positions and the bony bump is removed.  There are numerous surgical techniques for treating bunions.  Your doctor will discuss the most appropriate options for you.
 Bunion surgery is an outpatient surgical procedure.  An ankle-block anesthesia or general anesthesia may be used so that you do not feel pain during the procedure.  Following the surgery, the bones are held in position with wires, screws plates, or cast while they heal.
Before thinking about having surgery for your bunion, think about what bothers you the most about it. Is it the pain or the deformity? Are you looking to go back into high heels or narrow shoes? The best indication to have bunion surgery is pain. Having surgery mainly for cosmetic reasons can be disappointing in the end. Many bunions after surgical correction can come back to some degree, but in most patients this happens with very little pain, if any. Going back into high heels should not be part of your expectation.


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