Bunions and Hallux Valgus

Bunions, medically known as hallux valgus, are a common foot deformity involving a protrusion at the base of the big toe. This condition develops when the big toe starts to lean toward the second toe, leading to a misalignment of the bones in the foot.

The protruding bump on the side of the big toe joint reflects changes in the bony framework of the foot’s front part. Over time, this misalignment alters the angle of the bones, leading to the characteristic bunion bump.

Diagnosis of bunions and hallux valgus typically involves a combination of a physical examination and imaging tests.

• Physical Examination
  A surgeon will examine the foot, noting the presence and size of a bunion, checking for signs of pain or tenderness, and assessing the range of motion in the big toe. The overall alignment and condition of the foot will also be evaluated.
• Medical History Review
  The patient’s medical history and symptoms are reviewed to identify contributing factors or underlying health conditions.
• Gait Analysis
  Observing how the patient walks can help assess how the bunion affects their gait and identify compensatory patterns that may lead to other foot problems.
• Imaging Tests
  X-rays are commonly used to visualise the bones of the foot and the big toe joint, allowing the surgeon to assess the severity of the bunion and any associated arthritis. In some cases, imaging modalities like MRI or CT scans may be employed for a more detailed assessment.
• Assessment of Footwear
  The type of shoes worn by the patient may be examined to determine if they contribute to the bunion’s development or worsening.

Surgical intervention may be considered for bunions and hallux valgus when non-surgical treatments fail to relieve symptoms, or when the deformity is severe. Several surgical procedures exist, each tailored to the patient’s specific needs.

• Bunionectomy
  This is a basic procedure to remove the bunion and realign the toe. It is typically used for less severe deformities.
• Osteotomy
  In this procedure, the bones are cut and realigned, then held together with screws or pins. This is often accompanied by soft tissue correction to improve the alignment.
• Arthrodesis
  Joint fusion, or arthrodesis, involves fusing the joint bones. It is usually reserved for severe bunions or when previous surgery has failed.
• Resection Arthroplasty
  This involves removing damaged parts of the joint, which can relieve pain and is generally used for older patients or those with severe arthritis.
• Lapidus Procedure
  For severe bunions, this procedure fuses the joint where the metatarsal bone connects to the midfoot, providing stability and correcting the deformity.
• Minimally Invasive Surgery
  This approach uses smaller incisions and may result in quicker recovery times. It is suitable for certain types of bunions.