Bunion

Terms

It is an deformity on the medial site of 1st MTP joint and the  joint connecting with the big toe of the foot its known as the hallux.

It is an enlargement of bone or may be tissue around the joint at the bottom of the big toe. It is usually seen in metatarsophalangeal joint.

Physical Examination

  • Pain over the medial eminence, due to footwear.
  • Deformity.
  • on medial  site of 1st MTP.
  • Range of motion may be restricted, especially in dorsi-flexion.

Risks factor

  • Numbness in the big toe
  • The wound does not heal well
  • Continously pain.
  • Stiffness on the toe
  • Arthritis on the toe

There are 3 different stages:

Stage 1

  • Its usually seen adolescents to 25 y/o.
  • bunion presents as a slight bump.

Stage 2

  • from 25 y/o  to 55 y/o
  • 1st metatarsal head adducts, hallux abducts ,callosity on medial  site of 1st MTP joint
  • Foot continues to pronate.

Stage 3

  • overlapping of hallux either above or below  2nd  digit
  • rarely find footwear
  • extreme  pain, need surgical to correct.

Non-operative management

  • Footwear changes.
  • Drugs like NSAID.
  • Foot strengthening exercise.
  • Bunion strapping.

Surgical Method:

  • Hallux valgus based on the degree of deformity.
  • Dorsal Cheilectomy.
  • Modified McBride Procedure.
  • Distal Chevron Osteotomy.
  • Proximal Metatarsal Osteotomy.

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