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Bunions

Definition

A bunion is a bony deformity of the base of the big toe. It is characterised by a swelling and a deformity of the great toe- where the big toe angles outwards. The medical name for this is Hallux Valgus.

There are many reasons why bunions develop-  strong hereditary factors and footwear are thought to be amongst the most important.

The symptoms most people complain of are feet not fitting their shoes and rubbing against the bony prominences. Bunions deformities are commonly progressive and can affect both feet.

Diagnosis

Your doctor will take a history from you and examine your feet. It is vital to examine the whole of the foot to look for any other abnormalities and look for evidence of osteoarthritis at the base of the big toe (Metatarsophalangeal joint).

X-rays of the foot will also be taken which also help in detecting arthritis and are helpful in the planning for treatment of bunions.

Treatment

Non-operative

Bunions should be treated non-surgically to start with. This means wearing wider shoes that accommodate the deformity. This can help alleviate discomfort. An Orthotist can either make adaptations to existing footwear with the provision of pads, spacers and insoles or provide custom made footwear.

Operative

Surgery may be considered if the patient has not responded to non-operative management and their symptoms are severe. Surgery is usually effective- with 85% of cases resulting in improvement to symptoms.

The type of operation depends upon a number of factors such as the extent of the deformity and the presence of osteoarthritis. See our Treatment of Bunions Page

There are however complications of any form of surgery and those specific to bunion surgery are recurrence of deformity, infection and pain.

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