A bunion forms when the big toe and the bone it connects with become malaligned. This causes the bone to project on the inner side of the foot. The bones in the big toe are called phalanges and they connect to the first metatarsal forming the first metatarsophalangeal joint. The bump bunions form is made up of bone and soft tissue. The prolonged wearing of poorly fitting shoes (usually shoes with a narrow, pointed toe that squeeze the toes into an unnatural position) most often causes bunions. They often become painful when allowed to grow.
Many bunion problems can be managed without surgery and bunions that are not painful do not need surgical correction. Podiatrists do not recommend preventive surgery for bunions that do not hut because with proper preventive care they may never grow into a painful problem. The best way to prevent bunion pain is switching to shoes that fit properly and do not compress the toes. Podiatrists are excellent guides for choosing the best shoe to prevent bunions as well as other problems.
If nonsurgical treatment fails, surgery may become the only option. The common goal of these procedures is to realign the joint, relieve pain, and correct the deformity. Podiatrists have many options when choosing which surgery to correct a bunion. They base their decision from of the degree of malalignment, the length of the toe, health of the patient and physician preference. Terms used to explain the surgeries might be very confusing. Here are a few common words associated with bunion surgeries. An osteotomy is surgical cutting and removal of bone. An exostectomy is the removal of the bump on the first metatarsal. This procedure shaves the side of the bone off, is used only for a boney enlargement, and does not realign the bones. It is typically done in combination with other procedures. An arthrodesis is the removal of damaged bone around the joint followed by the insertion of screws, wires, or plates to hold the bones together until they heal. This procedure fuses the joint and is used for patients with severe bunions, arthritis, and when other procedures have failed. Bunion surgery is a great way to dramatically reduce pain and improve the alignment of the big toe. These surgeries are very common and a great way to restore normal function of the foot.
By Dr. Scott Hamilton of Coastal Podiatry Associates, Myrtle Beach, SC