Common Foot Disorder By Patrick A.DeHeer

If you look at the two x-rays below the one on the left is the preoperative x-ray. The goal of surgery as represented by the horizontal arrow is to move the first metatarsal bone closer to the second metatarsal. The x-ray on the right is the postoperative view and you can see the "tightrope" that has been drilled through both the first and second metatarsal bones and is held together by the black anchors. If any of you reading this section are contemplating having this procedure done, please discuss these potential complications with your surgeon. Bunions are bumps at the base of the big toe, on the outer side of the toe. They form when the big toe turns inward toward the second toe, gradually altering the big toe's skeletal structure, explains the American College of Foot and Ankle Surgeons. The angle of the bone causes a protrusion, and inflammation and pain may result. Bunions can make running particularly painful and difficult. Causes A bunion occurs as a result of a deformity in the big toe known as 'hallux valgus'. This is when the bone inside the foot which joins the big toe becomes displaced outwards and the joint rubs against the inside of footwear. The angle formed between the yellow and green line represents the hallux abductus angle or the deviation of the big toe (hallux) relative to the first metatarsal bones. If this angle is too large there are osteotomy procedures available (surgically breaking and re-aligning bone) to fix this angle as well. The next video demonstrates implant surgery for correction of a bunion. As just mentioned, this is generally done when your doctor determines that the cartilage is too worn out to be salvaged and is then replaced by an artificial joint. This procedure is sometimes performed in conjunction with an osteotomy procedure to realign the metatarsal and toe bones. Adequate physical examination to determine the etiology and specific deformity is necessary for treatment planning. Medical therapy can be used to address its cause, but it cannot change the irreversible cartilage, bony, and soft-tissue adaptations of the deformity. Consequently, most medical therapies are aimed at relieving the symptoms. Surgery to correct the underlying bone deformity may be indicated for bunions that do not respond to conservative treatment. Surgery is recommended if a bunion causes severe pain or if there is neuritis/nerve entrapment, the great toe overlaps/underlaps the second toe, or ulceration is present. Contraindications to surgery include active infection and extensive peripheral vascular disease. Tailor's bunion, also called a bunionette, occurs when the fifth metatarsal bone at the base of the little toe starts to expand outward forming a hard bony knot near the little toe, according to the website Foot Health Facts. This type of bunion is usually caused when pressure is continuously placed on the little toe joint due to a genetic foot abnormality or poorly fitted shoes. Wearing shoes that are too narrow in the toe can aggravate the bunion causing redness, swelling and pain at the site of the enlargement. Treatment usually consists of shoe modification padding, medication icing, corticosteroid injections and/or custom orthotic devices. Acute Bunions