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Hallux valgus, or commonly known as Bunion, is a condition that affects the joint at the base of the big toe. The base of the bone in your big toe (proximal phalanx) meets with the head of the metatarsal bone in your foot to form the metatarsophalangeal joint. Ligaments connect the two bones together for stability. Tendons attach muscles to the bones and allow movement. The metatarsophalangeal joint bends whenever you walk. The bunion actually refers to the bump that grows on the side of the first metatarsophalangeal joint (the big toe). Hallux valgus actually describes what is happening to the big toe; hallux is the medical term for big toe, and valgus means the deformity goes in a direction away from the midline of the body. As the big toe begins to point towards the outside of the foot other changes occur in the foot that increase the problem.
At first the bump is made up of irritated, swollen tissue that is constantly caught between the shoe and the bone beneath the skin. As the condition worsens, the constant pressure may cause the bone to thicken as well, creating an even larger bump to rub against the shoe.
Many problems that occur in the feet are the result of abnormal pressure or rubbing. Bunion is a great example of this. It is usually painful, and it becomes difficult to find shoes that are comfortable.
Non-surgical treatment nearly always starts with adapting shoe wear to fit the foot since the pain arises from the pressure from the shoe. There are also numerous devices, such as toe spacers, that attempt to splint the big toe. Sometimes, orthotics that support the arch and hold the big toe in better alignment, are recommended.
If all non-surgical measures fail to control the symptoms, then surgery may be the best option. In some mild cases, surgery called a bunionectomy may be required to remove the bump. It is more likely that realignment of the big toe will also be necessary. The major decision that must be made is whether the metatarsal bone will need to be cut and realigned as well. When a surgeon cuts and re-positions a bone, it is referred to as an osteotomy.
After surgery a patient is on a weight bearing restriction. 2-3 days post-surgery it is heel weight bearing only, in an orthopedic shoe. A scooter comes in very handy for wheeling around. It typically takes 6 weeks before the bones and soft tissue are well healed. X-rays will be taken at your 6 week follow up visit to see how much correction is achieved. Physical therapy can help restore strength and motion.
At Missoula Bone & Joint Foot and Ankle Specialty Clinic, both Dr. Brent Roster and Dr. Glenn Jarrett specialize in Bunion corrective surgery with successful outcomes. Call (406)721-4436 to schedule your consultation for a complete evaluation.