Posts for tag: bunion
A bunion, otherwise known as hallux abducto valgus, involves misalignment of the bones at the big toe joint and sometimes the joint within the big toe. This abnormal anatomy causes the boney prominence on the inside of the big toe. Conservative treatments vary, but surgery is the best treatment and extremely common. Some people avoid the surgery because they have heard stories and misconceptions. The surgery does typically require realignment of the bones through bone cuts and screws. The podiatrists at Coastal Podiatry Associates are well trained, having executed hundreds of bunion surgeries. The following statements are myths, especially when using Coastal Podiatry Associates.
Myth 1: Bunion Surgery is Extremely Painful
Bunion surgery is not different from other surgeries. In general, foot surgery can lead to increased pain due to swelling as the foot is below the level of the heart and blood can easily rush to the area. In addition, the foot has less soft tissue surrounding the bones, so moderate swelling can aggravate the nerves leading to pain. Swelling can be reduced through elevation and icing the affected foot.
Myth 2: Bunion Surgery Means a Cast and Crutches
Modern surgical techniques allow patients to mobilize quicker. Most bunion surgeries involve walking in a surgical shoe for six weeks. Mild surgeries can lead to an early return to shoes, while more complex surgeries may require casting and crutches.
Myth 3: You Have to be Off Work
As a general statement, this is not true. The amount of time away from work depends on the demands of the job and type of surgery. A patient can return to a sedentary desk job within two weeks of the surgery. However, jobs requiring excessive walking, standing, and physical activity may require a medical leave of absence.
Myth 4: Healing after Bunion Surgery Results in Unsightly Scars
Surgical healing is part of the process with any surgery. Newer techniques allow for smaller incisions and alternative surgical approaches may be used to hide surgical scars. Bunion incisions are either on the top of the foot or along the side, based on the surgeon’s technique. A surgeon may use a plastic surgery-type closure to minimize scaring.
Myth 5: Bunions Come Back After Surgery
Recurrence can happen after any surgery. The return of a bunion is no different, and it may be something that can happen over time. Patients that have excessive motion in the foot or do not reduce their risk for developing a bunion may experience a recurrence.
Feet are just like anything else, as they are used and time passes, change is inevitable. The average person takes approximately 10,000 steps per day, which can add up to more than 3 million steps a year. Each of these steps can place a force on your feet equal to two or three times your body weight. It is easy to see that with time, this extensive repetitive use can lead to several changes related to growing older.
Normal aging is associated with gradual stretching of the ligaments that support your foot’s anatomical shape. It is normal to notice your feet becoming wider and longer. This is generally combined with a mild settling of the foot’s arch more often noticed as a flattening of the foot. Another normal change is thinning of the skin on the bottom of the heel. This is from a reduction of a fat pad as the body loses its ability to retain water. Again, normal aging is the corporate. An increase in the stiffness of joints and a loss of joint range of motion may occur. Think back to the facts of taking 10,000 steps where 2-3 times your body weight is placed on your feet, this workload on your joints will cause a natural amount of arthritis that can lead to stiffness.
Some common foot changes are abnormal or pathological. These conditions tend to occur in association with prolonged use of ill-fitting shoes and extreme stress placed on the foot. They are most commonly noticed when people are in their 30s, 40s, and 50s. These problems do not occur naturally and can be slowed or prevented with the use of proper shoes and inserts. A bunion is the most common problem and is a large bump on the inside of the big toe. Another condition is a hammer digit, which occurs when the toe becomes curled or constantly bent. Bunionette is a term used to describe a large bump found on the outside of the smallest toe in addition to the toe pointing toward the rest of the foot. Calluses or corns can occur on the toes or foot in areas of high pressure points. If you notice these changes, it is important to get your feet checked by a doctor. Podiatrists are specially trained to treat these conditions and reduce the associated discomfort or pain.
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