Bunion
Hallux Valgus Deformity
What is a Bunion?
The common bunion is a localized area of enlargement of the inner portion of the joint at the base of the big toe. The enlargement actually represents a misalignment of the big toe joint (metatarsal phalangeal joint) and, in some cases, additional bone formation. It is a structural forefoot varus in which the big toe (first ray) splays outward, putting pressure on the first metatarsal head.
Varus - position of a body part that is bent inward
Varus - position of a body part that is bent inward
Signs/ Symptoms
Signs include tenderness, swelling, and enlargement of the joint. As inflammation continues, angulation of
the toe progresses, leading to painful ambulation (walking).
the toe progresses, leading to painful ambulation (walking).
Mechanism of Injury
It can be hereditary. Bunions occur when pressure is applied to the big toe, forcing it inward towards the second digit. Bunions are caused by shoes that are too pointed, too narrow, or too short. Bunions are also caused by being flat footed, which results in joint hypermobility and soft tissue flexibility. Being flat footed increases forces on the first metatarsal head, and it creates tension on the medial side of the joint, which can affect bone growth.
Structures Involved
The bursa over the first metatarsophalangeal joint becomes inflamed and thickens.
Bursa - A fluid filled sac or sac-like cavity, especially one encountering friction at a joint.
Bursa - A fluid filled sac or sac-like cavity, especially one encountering friction at a joint.
Injury Can Lead To:
• Tendonitis in the flexor tendons of the Great Toe
• The joint becomes so enlarged and the great toe becomes malaligned, moving laterally towards the second toe, sometimes overlapping the second toe.
Tendonitis - inflammation,irritation, and swelling of a tendon, which is the fibrous structure that joins muscle to bone. In many cases, tendinosis (tendon degeneration) is also present.
• The joint becomes so enlarged and the great toe becomes malaligned, moving laterally towards the second toe, sometimes overlapping the second toe.
Tendonitis - inflammation,irritation, and swelling of a tendon, which is the fibrous structure that joins muscle to bone. In many cases, tendinosis (tendon degeneration) is also present.
Taping/Corrective Techniques
• Orthotic to correct a structural forefoot varus deformity
• Place a felt sponge or rubber doughnut pad over the first metatarsophalangeal joint
• Wear a tape splint along with a resilient wedge placed between the big toe and second toe
• Wear correctly fitting shoes
• Engage in daily foot exercises to strengthen the extensor and flexor
muscles
• A surgical procedure called a bunionectomy
may be necessary
• Place a felt sponge or rubber doughnut pad over the first metatarsophalangeal joint
• Wear a tape splint along with a resilient wedge placed between the big toe and second toe
• Wear correctly fitting shoes
• Engage in daily foot exercises to strengthen the extensor and flexor
muscles
• A surgical procedure called a bunionectomy
may be necessary
Bunion Surgery (Bunionectomy)
An incision is made in the top of the foot. The overgrowth and fluid-filled sac called a bursa are removed. The phalanx bone of the big toe is shortened to straighten it. The most significant portion of the bunion surgery is re-aligning the bones. This is performed though bone cuts or a fusion involving the first metatarsal. The severity of the bunion determines where the bone will be cut or fused. The foot is realigned, and the incision is closed. The goal of the surgery is reduction of pain.