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What is a Bunion?
 
Normal toe
 
Bunion

A bunion is a commonly misunderstood foot deformity. Most people see the prominence on the side of their great toe and assume that this represents a bump or lump on the bone of the great toe. The main purpose of the diagram is to show that the bunion is formed by the angle created by two bones.

It is a very difficult deformity to treat surgically because once the bones start to move it is difficult to halt their progression. The only treatment that can stop a bunion from getting larger and also reduce bunion pain is an orthotic. Orthotics change the position of the feet and reduce how much weight is being transferred to the bunion site.

Not all bunions are painful but if they are painful it is either in the outer aspect which people refer to as the "bump" or in the joint itself. Many complaints seem to begin after the involvement of court sports. This is basically due to the fact that the lateral motion required in court sport puts pressure on the great toe joint due to the pivotal motion required. Many people seem to have an aching or sharp sensation in the first toe joint after a strenuous game of racquetball or handball.

Type of surgical correction
 
Surgical correction

Another misconception seems to be in how a bunion gets started. Many people believe their bunions started because they wore too tight, pointed or high heeled shoes. All these conditions may have initiated or helped in the progression of the bunion but it is certainly not the reason the bunion got started. Bunions are hereditary and when asked, most people can remember some great aunt or grandparent who also had the deformity.

Treatment is usually surgical. Either by using bone cuts as shown in the diagram above or by placing an artificial implant in the joint. The implant is necessary when the joint is worn away by trauma or if the bunion has been present for a very long while. Bunion surgery is usually performed by making cuts in the bone fixated by screws which hold the bones in their corrected position. A vast majority of the patients can walk very soon after surgery a situation so unlike the "old days" when most patients had to be completely non-weight bearing.

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