A bunion (Hallux Valgus) is a deformity of the metatarsophalangeal (MTP) joint at the base of the big toe. A bunion develops when the first metatarsal bone of the foot turns outward and the big toe points inward (toward the other toes), causing the joint to jut out
High heels can exacerbate the problem because they tip the body's weight forward, forcing the toes into the front of the shoe. This may help to explain why bunions are 10 times more common in women than in men.
Hallux Valgus angle (HVA) >15° or Intermetatarsal angle (IMA)
>9° indicate Hallux Valgus.
- Bunionectomy or Exostectomy - Shaves the bony excess on the outside of the metatarsal head. Realigns the muscles, tendons, and ligaments surrounding the joint. May not correct the deformity that caused the bunion. Distal metatarsal head osteotomies (the first 2 below) are the most popular surgeries. - Austin/Chevron Procedure or Long Arm Osteotomy - Cutting (Osteotomy) of the metatarsal head to shift it into proper alignment. The bone is held in place with screws or pins. During this surgery, bone is removed from your toe. Nearby tendons and ligaments are made shorter or longer as needed. This allows your big toe to line up (align) properly. Video - Opening Wedge Bunionectomy - A wedge of bone is placed in the bone cut to correct and close the abnormal angle between the 1st and 2nd metatarsals. Donor bone graft or bone harvested from the patient can be used for this correction. - Keller Procedure or First MTP Joint Arthroplasty ("old lady" bunionectomy) This is the most common type of bunionectomy performed on older patients with severe deformities and less than optimal bone stock. Your surgeon takes the extra bone off from the side of the joint, then makes a cut in the bone removing part of the joint. Then a wedge of soft tissue is placed in between the pieces of bone to alleviate bone on bone contact. See Is the Keller Bunionectomy Outdated? | Podiatry Today - Lapidus Bunionectomy - The first metatarsal-cuneiform joint is removed in a "pie wedge" manner. This allows for the entire 1st metatarsal to shift toward the 2nd metatarsal, in a correct position. The lapidus bunionectomy is considered the Gold Standard for bunion surgery. For the right patient, this procedure has the highest success rates with essentially a 0% chance of the bunion returning. - Mini Tightrope® A a less invasive procedure Holes are drilled in the first and second metatarsal bones and a thin wire is run between them and fastened on the other side of each bone pulling them together. See also Dr. Charles J Sidlow, Georgia - Mini-Tightrope Bunionectomy - Bunionplasty℠ - A technique expoused by Dr. Neal Blitz in New York. The only things I could see that were different was less scaring with the incision and he developed a medical implant that holds the bone steady while healing so, he is able to allow patients to put immediate weight on the foot right after the surgery no matter the size of the bunion. See: Bunionplasty: A Plastic Foot Surgery Craze? | HuffPost More at Bunion Surgeries | FootDoc.caRealigning the muscles, tendons, and ligaments can be done with any of the above.
Outcomes and complications of bunion surgery:
Variations among toe-joint deformities and surgical techniques make it difficult to evaluate the results of bunion surgery. Some studies suggest that 85% to 90% of patients are satisfied with their results, but one review found that about a third of patients were dissatisfied even when their pain and toe alignment improved. The problem may be unrealistic expectations.
Surgical complications at UK National Health Service (NHS)
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Devices such as splints and toe spreaders might make you feel better but there's no evidence that they correct alignment or prevent bunion progression (CR).
Running with Bunions:
Bunions will cause problems for runners. Some things to try.
Get extra wide men's shoes.
Bunion Surgery | WebMD
Bones of the Foot
Bunion Surgery: The Complete Patient Guide
Types of Bunion Surgery, Lapidus Bunionectomy
What to do about bunions - Harvard Health
Osteotomy and Ligament or Tendon Repair (Bunion Surgery) | SaintLukesHealthsystem
Bunion Myths, Misconceptions, and Treatments: 10 Things You've Always Wanted to Know To Treat Your Feet - Healing Feet
Austin Bunionectomy Surgery With Screw Fixation | - YouTube
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