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What Is A A Bunionectomy?

Overview
Bunions
A bunion is an enlargement at the base of the big toe caused by a misalignment of the joint. Hallux valgus or hallux abducto valgus (HAV) is the name used for the deviated position. of the big toe and a bunion refers to the enlargement of the joint, most of the time the two go together and can just be referred to as ?bunions?. Bunions are really only a symptom of faulty foot mechanics and are usually caused by the foot we inherit and inappropriate footwear use. As the big toe bends towards the others this lump becomes larger and the bunion can become painful - arthritis and stiffness can eventually develop.


Causes
Many problems that occur in the feet are the result of abnormal pressure or rubbing. One way of understanding what happens in the foot due to abnormal pressure is to view the foot simply. Our simple model of a foot is made up of hard bone covered by soft tissue that we then put a shoe on top of. Most of the symptoms that develop over time are because the skin and soft tissue are caught between the hard bone on the inside and the hard shoe on the outside. Any prominence, or bump, in the bone will make the situation even worse over the bump. Skin responds to constant rubbing and pressure by forming a callus. The soft tissues underneath the skin respond to the constant pressure and rubbing by growing thicker. Both the thick callus and the thick soft tissues under the callus are irritated and painful. The answer to decreasing the pain is to remove the pressure. The pressure can be reduced from the outside by changing the pressure from the shoes. The pressure can be reduced from the inside by surgically removing any bony prominence.


Symptoms
If you have a bunion, you may have pain or stiffness of your big toe joint, swelling of your big toe joint, difficulty walking, difficulty finding shoes that fit. These symptoms may be caused by conditions other than bunions, but if you have any of these symptoms, see your doctor.


Diagnosis
Before examining your foot, the doctor will ask you about the types of shoes you wear and how often you wear them. He or she also will ask if anyone else in your family has had bunions or if you have had any previous injury to the foot. In most cases, your doctor can diagnose a bunion just by examining your foot. During this exam, you will be asked to move your big toe up and down to see if you can move it as much as you should be able to. The doctor also will look for signs of redness and swelling and ask if the area is painful. Your doctor may want to order X-rays of the foot to check for other causes of pain, to determine whether there is significant arthritis and to see if the bones are aligned properly.


Non Surgical Treatment
The treatment of a bunion depends entirely on how uncomfortable it is. Realistically, there are only two ways to treat a bunion: either change the size and shape of the shoe or change the size and shape of the foot. Once a bunion gets to be irritating or painful and shoe wear is uncomfortable, surgery may be recommended.
Bunion Pain


Surgical Treatment
The type of surgical procedure performed depends upon the severity of the bunion, the individual?s age, general health, activity level, and the condition of the bones and connective tissue. Other factors may influence the choice of a procedure used. Mild bunion. For this type of surgery, the surgeon may remove the enlarged portion of bone and realign the muscles, tendons, and ligaments surrounding the joint. Moderate bunion. For a moderate bunion, the surgeon may cut the bone and shift it to its proper position. Whether or not the bone is cut depends on the severity and location of the deformity. In addition, the surrounding tendons and ligaments may need to be repositioned. Severe bunion. For a severe bunion, surgery may involve removing the enlarged portion of the bone, cutting and realigning the bone, and correcting the position of the tendons and ligaments. Arthritic bunion or big toe joint. If the joint is damaged beyond repair, as is commonly seen in arthritis, it may need to be reconstructed or replaced with an artificial joint. Joint replacement implants may be used in the reconstruction of the big toe joint.

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