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BRIAN E. STRAUS, M.D.
FOOT AND ANKLE SPECIALIST, TEXAS SPORTS MEDICINE
BOARD ELIGIBLE, American Board of Orthopaedic Surgery
Candidate Member, American Academy of Orthopaedic Surgeons
CANDIDATE MEMBER, American Orthopaedic Foot and Ankle Society
APPROVED DOCTOR (ADL), Texas Division of Workers' Compensation
ASSISTANT TEAM PHYSICIAN, Dallas Mavericks
Bunions
What is a bunion?
A bunion (hallux valgus) is an enlargement of the bone or tissue around a joint at the base of the big toe or at the base of the little toe (in which case it is called a "bunionette" or "tailor's bunion"). Bunions often occur when the joint is stressed over a prolonged period. They are nine times more common in women than in men, primarily because women may be more likely to wear tight, pointed, and confining shoes. Bunions may be inherited as a family trait. Bunions may also result from arthritis, which often affects the big toe joint.
Often in the initial stages bunions may be painless and symptoms only occur in tight or high heeled shoes. In the later stages the big toe can press on the second toe producing interdigital corns. The big toe may also pass underneath the second toe causing the second MTP joint to cock up (become a hammer toe) and eventually may dislocate.
Treatment of Bunions
The nonsurgical treatment involves using wider or deeper shoes. If the structures on the inside are being stretched, then a toe separator can sometimes be helpful. The role of insoles in bunions is somewhat controversial. Some patients with flat feet do have accentuation of their deformity with weight bearing, and in these patients an arch support may help. The definitive treatment for bunions, however, is surgical. In general one has to move the bone and re-align the joint, rather than simply removing bone from the foot. There are a variety of procedures that may be performed and depend on the severity of the bunion. Following bunion surgery patients have to wear an orthopaedic sandal or walking boot for a period of time and can expect swelling in this foot for approximately six months.
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