Bunions

What are Bunions?

A bunion—also called Hallux Valgus—is a bump that appears inside the foot, around the metatarsophalangeal (MTP) joint (near the big toe). This bump is actually a bone protruding towards the inside of the big foot. Left untreated, bunions can cause sever pain and even hinder walking abilities.

Bunions are a common problem most women deal with, but men develop them too. Most people develop bunions from wearing poor-fitting shoes—though they can also be passed down genetically as well.

Types of Bunions

Bunions typically develop when the weight of your body falls unevenly on the joints and tendons in your feet. This is usually due to poor-fitting shoes or genetic deformities. The most common types of bunions include:

• Tailors bunion: Also called a bunionette, Tailors bunions occur when the fifth metatarsal bone (smallest toe) starts to expand outward, forming a bony growth near the little toe.
• Acute bunion: This condition causes bony masses to form near the toe joints as a result of bursitis.
• Adolescent bunion: Teenagers may develop a bunion at the vase of his or her big toe. This bunion may cause pain and can get worse over time without treatment.

How is a Bunion Treated?

If left untreated, bunions can become so painful that you might end up walking differently just to relieve the pressure. Because the MTP joint helps bear and distribute bodyweight while standing, bunions can seriously affect the foots ability to function properly.

To treat bunions, your healthcare provider will begin with conservative methods designed to relieve pressure and restore function. The most common conservative approaches to alleviating bunions include:

• Shoe choice: Choose shoes with wide insteps, broad toes and soft soles and avoid shoes that are narrow, tight, or sharply pointed.
• Custom orthotics: In order to relieve pressure from the affected areas, your doctor may recommend custom shoe inserts.
• Forefoot products: Products like a bunion shield, night splint or bunion bandages may be prescribed to treat bunions.

Conservative approaches like these are designed to limit the progression of the bunion, relieve pain, and provide a healthy environment for the foot. In more serious cases, bunion surgery may be recommended.

About Bunion Surgery

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Many different types of procedures have been described for the treatment of Bunions. Over the course of time, Bunion surgery techniques have improved considerably. They are much more reproducible and can be performed with minimal post-op discomfort and a shorter recovery time. One of the keys that have lead to this change was the FDA’s approval of a new type of implantable screw. The “bold screw” is a headless screw that enables patients to return to both shoes and activities of daily living much sooner than with the first generation of screws. Because the screw head is missing, the screws can be placed beneath the surface of the bone, avoiding the need for retrieval, and can be placed on an angle allowing better fixation on the bone. This new technology is one that was invented by one of the world’s most prominent foot surgeons.

The procedure involves a “Z” cut through the bone, allowing the bone to be repositioned in a way to narrow the foot. The titanium “bold screws” are placed across the osteomy (cut), enabling the bone to be rigidly held in the new corrected position. The high torque exerted by the screw enables the bone to heal from the inside out, eliminating the need for casts and crutches. Restricted ambulation is advised for the first 48 hours following surgery. Walking is permitted with the use of a flat surgical shoe. Depending on age and health, the surgical shoe can be discarded at 2-3 weeks and soft running shoes can be worn for 3 weeks. Sutures remain in place for about 2 weeks, at which time normal bathing can be resumed. The return to stylish shoes and sports can vary from patient to patient, but usually takes about 10 weeks following the surgery.

The procedure is generally performed under light sedation without an overnight stay. The success rate combining this new technology with the Z Bunionectomy is between 90% and 95%. In most instances, people are back walking a mile within 6 weeks from the date of surgery. The costs of this procedure are covered by insurance.