Reasons to undergo bunion surgery may include severe foot pain that occurs even when walking or wearing flat, comfortable shoes. Surgery may also be indicated when chronic big toe inflammation and swelling does not subside with rest or medications. Other reasons for surgery include toe deformity, a drifting in of the big toe toward the small toe, and an inability to bend and straighten the big toe. Other complications may include recurrence of the bunion, nerve damage, and continued pain. The surgery may also result in overcorrection of the problem, in which the big toe extends away from the other toes.
Bösch et al 5 first performed this technique in 1984. In a study of 114 patients with long-term follow-up, they demonstrated satisfactory correction of the intermetatarsal and metatarsophalangeal angles with no complications of hallux varus, pseudoarthrosis, or osteonecrosis of the metatarsal head. Magnan et al 7 reported on 118 patients with an average follow-up of 36 months, with good clinical results (91%) and a low recurrence rate (2.5%). The average angular correction obtained was 5° and 7.5° for the intermetatarsal and metatarsophalangeal angle, respectively. 7 Always select well fitting comfortable shoes for wearing and always make sure that your shoes are not irritating or rubbing your pedal skin.
Through an incision (cut), the bunion (part of the bone that sticks out) is removed with a surgical saw or chisel. In some cases this might be enough to correct the deformity. However in more severe cases, extra correction (osteotomy) is needed. A cut is made at the head of the first metatarsal. This allows the bone to be repositioned. Before realignment is complete, tendons that attach to the big toe may need to be cut, or released, to relieve the inward pull on the toe. Normal activities can usually be resumed, after the bones and soft tissue have healed (normally within six to eight weeks). Bunionectomy with Wedge Osteotomy
The term hallux valgus denotes deviation of the great toe toward thefibular border of the foot. Hallux valgus is not synonymous with bunion,which is derived from the same root as “bun” or “bunch”,and means an area of swelling. In connection with the foot, bunion usuallyrefers to the prominent medial portion of the first metatarsal head andespecially to the bursa or a bursa plus osteophyte over it, when this exists.A bursa and/or osteophyte may or may not accompany hallux valgus. Same patient as figure above, but now in shoes with 3 inchheels. The intermetatarsal angle has widened in both feet, and a functionalhallux valgus has developed, due to her constricting shoes.
Don’t hold back until your heel spur symptoms get worse before you decide to seek help. Starting your heel pain treatment promptly saves you the anguish of walking with swollen ligaments. You don’t have to put your active lifestyle on hold. read more There are many symptoms of a bunion like swelling, redness or pain at the bottom of the big toe. Initially a bunion could be gifted as non-painful detachment of your big toe towards the others. Because the toe progresses towards the corns, calluses and the malformation of the other toes occur. You will also experience restricted big toe motion.
Participants in the CME program can manage their CME points with their 15-digit “uniform CME number” ( einheitliche Fortbildungsnummer , EFN). The EFN must be entered in the appropriate field in the cme.aerzteblatt.de website under “meine Daten” (“my data”), or upon registration. The EFN appears on each participant’s CME certificate. The solutions to the following questions will be published in issue 5/2013. The CME unit “The Diagnosis and Management of Dyscalculia” (issue 45/2012) can be accessed until 21 December 2012. Please answer the following questions to participate in our certified Continuing Medical Education program. Only one answer is possible per question. Please select the answer that is most appropriate.