The term bunion refers to a deformity of the forefoot in which there is an enlargement over the inner aspect of the metatarsal head of the great toe.
This is a common and disabling deformity in which the patient experiences pain when wearing shoes. Occasionally intermittent numbness in the area of the great toe is experienced. Chronic thickening over the bunion and occasionally infection can result.
Why a bunion develops is not completely understood. It is known that bunions can run in families and I often see grandparents, parents, and children with hereditary bunions. Probably the most important factor in the development of a bunion deformity is poor shoes. Over 90% of the bunion operations I do are on females. I believe the cause of bunions can definitely be attributed to poor shoes-mainly high heeled shoes with pointed toes.
The goal of treatment of a bunion is foot comfort. In early bunion deformities, the use of soft leather shoes that provide a wide toe box to minimize pressure over the bunion is the treatment of choice. As the deformity progresses, surgery may need to be done to correct the deformity. There are many different types of bunion repairs designed for different foot deformities. Further discussion about surgical repair is completed prior to scheduling surgery.
Following surgery, careful postoperative care is need in order to keep the toe and metatarsal in proper alignment. Frequent office visits are necessary to inspect the incisions and to re-wrap the foot in a corrected fashion. It is not usually necessary to be cast postoperatively and usually a compression dressing with toe strapping will be used for 8 weeks and the patient will use a bunion shoe to walk in during this period of time.