Bunions
Bunions
Bunions are a common foot disorder seen in podiatry. Patients use this term to describe the bony lump found near the base of the big toe, which is usually an adaptation of the positional change of the big toe. Hallux abducto valgus (HAV) is a medical term, which describes the position of the hallux (big toe) with respect to the connecting bone of the mid foot (metatarsal). In this foot disorder, the hallux deviates towards the lesser toes whilst the metatarsal moves towards the midline. The most common causative factor is inheriting a foot type from your family that is prone to bunions. Feet that are subjected to pronation also have a higher incidence of attaining HAV deformities. This is a problem that has many causes with more than one potentially occurring at the same time.
There are many reasons why this deformity occurs such as:
- Hereditary factors
- Footwear habits
- Foot type
- Biomechanical factors (pronation)
- Neuromuscular dysfunction
The Treatment
There are two ways to treat this pathological foot conditions, conservatively and surgically. Conservative treatment is the first line treatment which consists of splints and orthotic care to reduce the causative factors. Orthotics help realign the foot, thus preventing further degeneration and/or reducing symptoms of HAV in any stage of its deformity. In addition to orthotic care, patients may require debridement of corns and calluses produced due to extra forces produced on the foot.
Orthotics will also help the function of the big toe joint as it allows it to bend in the correct position. Footwear advice is also essential in the conservative care of HAV, for that reason there may be a need to change footwear, so it is able to fit properly and be compliment with orthotics.
Surgical correction of HAV is available, however should only be considered when conservative care has failed to reduce the onset of HAV. It is only considered if there is a clear sign that it will induce a better quality of life for the patient.
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