A bunion (hallux abducto valgus) is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place.

The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.

Despite popular belief wearing shoes that are too tight is not a cause of bunions but rather an aggravating factor that contributes to pain. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.

Treatment for Bunions

Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:

• Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.



• Removal of corns and calluses on the foot.
• Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
• Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.



• Exercises to maintain joint mobility and prevent stiffness or arthritis.
• Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.

Surgical Treatment

Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.

Pre-operative

Post-operative

How Am I Evaluated For Surgery

During your physical examination with Dr. Fahoury, your gait, biomechanical structure, degree of deformity, joint alignment,bone, joint and bone integrity and secondary factors such as hammertoes or other associated deformities will be accessed. The most appropriate procedure for you will be determined based on these factors as well as your activity level, age and any underlying risk factors.

How is My Bunion Corrected

Modern bunion correction is markedly different from the older procedures that often required casts and crutches and extended peroids of disability.

While there are many types of procedures to correct a bunion depending on the factors discussed above, essentially all usually involve reducing the angle between the 1stosteotomy (cut in the bone) of some type and realignment of the big toe joint. This is usually done under local anesthesia with IV conscious sedation on an outpatient basis.

Post-Operatively what Can I Expect?

Depending on the procedure, post-operatively a bandage, ace and surgical shoe are applied to the operative foot. It is recommended that you stay home with your foot elevated and iced to minimizepost-operative swelling for 3 to 4 days. Discomfort if any is address with post-operative pain meds prescribed by Dr. Fahoury. Your 1st in a comfortable sneaker or walking shoe in 1 month and begin athletic activities in 2 ½ to 3 months and 2d metatarsals via an post-op visit is with in 4 days. Usually Patient are able to ambulate