Bunion

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bunion is the connection deformity that connects the big toe to the foot. Big toes often bend toward other toes and joints become red and painful. Gradual onset. Complications may include bursitis or arthritis.

The exact cause is not clear. The proposed factors include wearing too-tight shoes, family history, and rheumatoid arthritis. Diagnosis is generally symptomatic and supported by X-rays. A similar condition of the little finger is called a bunionette.

Treatment may include proper shoes, orthotics, or NSAIDs. If this is not effective for improving symptoms, surgery may be performed. It affects about 23% of adults. Women are more often affected than men. Usually the age of onset is between 20 and 50 years. This condition also becomes more common with age. This was first explained clearly in 1870.

Video Bunion

Signs and symptoms

Bunion symptoms include irritated skin around the bunion, pain when walking, redness and joint pain, and the possibility of shifting the big toe toward the other toes. Blisters can form more easily around the bunion site as well.

The presence of a bunion can cause difficulty finding the right footwear and can force a person to buy larger sized shoes to accommodate the width of the bunion made. If the bunion deformity becomes severe enough, the foot can be injured in different places even without the narrowing of the shoe. This is then regarded as a mechanical function problem of the forefoot.

Maps Bunion

Cause

The exact cause is not clear. The proposed factors include wearing too-tight shoes, family history, and rheumatoid arthritis. Some countries claim that footwear only exacerbates problems caused by genetics.

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Pathophysiology

The lump itself is partly caused by a swollen bursal sac or an osseous anomaly (bone) in the metatarsophalangeal joint. The larger part of the lump is the normal part of the first metatarsal bone head that has been tilted sideways to protrude at the distal (distant) end.

Bunion is generally associated with a distorted position from the big toe toward the second toe, and the distortion at the angle between the first and second metatarsal bones in the legs. Small sesamoid bones found beneath the first metatarsal (which helps the flexor tendon bend the big toe down) can also deviate over time when the first metatarsal bone drifts away from its normal position. Osteoarthritis of the first metatarsophalangeal joint, decreased and/or various movements altered, and discomfort with pressure applied to the lump or with joint motion, may all accompany the development of the bunion. Above the first metatarsal head either medial or dorso-medial, there may also be an exchange which, when inflamed (bursitis), can be the most painful aspect of the process.

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Diagnosis

Bunions can be diagnosed and analyzed with ordinary projection radiographs, which must withstand weight. The hallux valgus angle (HVA) is the angle between the longitudinal axes of the proximal phalanx and the first metatarsal bone of the big toe. This is considered abnormal if it is more than 15-18 Â °. The following HVA angles can also be used to assess the severity of hallux valgus:

• Lightweight: 15-20Ã, Â °
• Medium: 21-39Ã, Â °
• Severe:> = 40Ã, Â °

The intermetatarsal angle (IMA) is the angle between the longitudinal axis of the first and second metatarsal bones, and usually less than 9Ã, Â °. The IMA angle can also assess the severity of hallux valgus as:

• Lightweight: 9-11Ã, Â °
• Moderate: 12-17Ã, Â °
• Severe:> = 18Ã, Â °

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Treatment

Conservative treatment for bunions includes changes in footwear, use of orthotics (cushion and accommodative shelter), rest, ice, and pain medications such as acetaminophen or nonsteroidal anti-inflammatory drugs. This treatment overcomes symptoms but does not correct the actual abnormalities. If discomfort continues and severe or when aesthetic correction of the desired deformity, surgical correction by an orthopedic surgeon or podiatric surgeon may be necessary.

Orthotics

Orthotics are splints or regulators while conservative measures include footwear such as foot gel spacers, bunion/toe separators, bunion regulators, bunion splints, and bunion cushions. There are various orthotics available (or orthoses) including commercial products that are freely sold or off-shelf and if necessary, specially formulated orthotics which are generally defined medical devices.

Surgery

The procedure is designed and selected to improve the various pathologies that may be associated with the bunion. For example, a procedure might discuss some combinations:

• removes the abnormal bone enlargement from the first metatarsal,
• realigns the first relative metatarsal bone to the adjacent metatarsal bone,
• stretching a large toe relative to the first metatarsal and adjacent radius,
• sets the cartilaginous surface of the big toe joint,
• handle rheumatic changes associated with large toe joints,
• repositioning the sesamoid bone beneath the first metatarsal bone,
• shorten, lengthen, increase, or lower the first metatarsal bone,
• corrects all bending or abnormal misalignment inside the big toe,
• connect two parallel long bones alongside the syndesmosis procedure

There are currently many different bunion operations for different effects. Age, health, lifestyle and patient activity levels can also play a role in the choice of procedures.

Traditional bunion surgery can be performed under local, spinal or general anesthesia. A person who has undergone bunion surgery can expect a 6-8 week recovery period in which crutches are usually required to assist mobility. The orthopedic cast is currently less common because newer, more stable procedures and improved form of fixation (stabilizing bones with screws and other hardware) are used. The hardware can even include an absorbable pin that performs its functions and is then broken down by the body for months. After restoration of long-term stiffness or limited range of motion can occur in some patients. Visible or limited scarring may also occur in patients.

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References

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External links

• Textbooks from Hallux Valgus and ForeFoot Operations , links to full text in PDF files

Source of the article : Wikipedia