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All The Things You Want To Find Out Related To Bunions

Overview
Bunions Hard Skin
A bunion is an enlargement of bone at the great toe joint. Tight shoes don’t cause bunions, but they can aggravate them. Bunions are often inherited and become worse over time if left untreated they can cause pain, swelling, skin irritation and other foot problems. Bunion deformities are often part of a more generalized problem related to improper foot motion. There are presently over 25 types of bunion procedures performed today. The choice of procedure is based on many factors.


Causes
Bunions form when the normal balance of forces exerted on the joints and tendons of your feet are disrupted. This can lead to instability in the big toe joint - also known as the first metatarsophalangeal (MTP) joint, causing a deformity. Bunions develop over years of abnormal motion and pressure on your big toe joint. They often result from a combination of your inherited foot type, faulty foot mechanics that affect the way you walk and shoes that fit improperly. Other causes of bunions include foot injuries. Deformities present at birth (congenital). Neuromuscular disorders, such as cerebral palsy or post- polio syndrome (post-poliomyelitis). Bunions may be associated with various forms of arthritis, including inflammatory or degenerative, causing the protective cartilage that covers your big toe joint to deteriorate. An occupation that puts extra stress on your feet also can be a cause. Waiters, factory workers, dancers and athletes often are more prone to developing bunions.


Symptoms
The pain from a bunion is felt around the MTP joint of the big toe. People with bunions often complain of pain when they when they stand or walk for long periods of time. High heeled shoes or shoes with a small toe area can make bunions feel and look worse. As a result of the deformity the big toe can lose some of its range of motion or become stiff. Sometimes both feet are affected.


Diagnosis
Generally, observation is adequate to diagnose a bunion, as the bump is obvious on the side of the foot or base of the big toe. However, your physician may order X-rays that will show the extent of the deformity of the foot.


Non Surgical Treatment
Non-surgical treatments for bunions may include wearing shoes that fit and that have adequate toe room. Stretching shoes professionally to make them larger. Putting bunion pads over the bunion to cushion the pain. Avoiding activities that cause pain, such as being on your feet for long periods of time. Taking over-the-counter pain relievers when necessary, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen. Using ice to provide relief from inflammation and pain. Using custom-made orthotic devices.
Bunions


Surgical Treatment
When a surgeon cuts and repositions a bone, it is referred to as an osteotomy. There are two basic techniques used to perform an osteotomy to realign the first metatarsal. In some cases, the far end of the bone is cut and moved laterally (called a distal osteotomy). This effectively reduces the angle between the first and second metatarsal bones. This type of procedure usually requires one or two small incisions in the foot. Once the surgeon is satisfied with the position of the bones, the osteotomy is held in the desired position with one, or several, metal pins. Once the bone heals, the pin is removed. The metal pins are usually removed between three and six weeks following surgery. In other situations, the first metatarsal is cut at the near end of the bone (called a proximal osteotomy). This type of procedure usually requires two or three small incisions in the foot. Once the skin is opened the surgeon performs the osteotomy. The bone is then realigned and held in place with metal pins until it heals. Again, this reduces the angle between the first and second metatarsal bones. Realignment of the big toe is then done by releasing the tight structures on the lateral, or outer, side of the first MTP joint. This includes the tight joint capsule and the tendon of the adductor hallucis muscle. This muscle tends to pull the big toe inward. By releasing the tendon, the toe is no longer pulled out of alignment. The toe is realigned and the joint capsule on the side of the big toe closest to the other toe is tightened to keep the toe straight, or balanced. Once the surgeon is satisfied that the toe is straight and well balanced, the skin incisions are closed with small stitches. A bulky bandage is applied to the foot before you are returned to the recovery room.

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