There are many misconceptions about bunions. Bunions are most commonly described as a bump on the side of the foot. However, a bunion can be much more than that. Most often bunions are actually a representation of change in the bony framework of the foot. The primary contributing factor to a bunion deformity is inherited. Yes, you get this from your parents or grandparents, and is common among relatives. No you don't get bunions from shoes. But wait, shoes do affect how a person's bunion may feel. Wearing shoes that crowd the toes, will also press on the bump and cause pain. Also, in theory the deforming forces on the joint can be increased with less supportive shoes. Yes, flip flops and very high heels can make your bunions worse. Changing your shoes and wearing orthotics (arch supports) can be helpful, and many do very well with conservative treatment for many years.
For some correcting the bony alignment with Bunion Surgery is the best solution. For those who have been managing their bunion with appropriate shoes, and continue to have pain that is “keeping them from the activity they would like to do”, Bunion Surgery may be the best option. Currently, Osteotomy is the most common procedure for bunionectomy. A Distal Osteotomy, otherwise know as a Chevron or Austin Bunionectomy, requires 6 to 8 weeks for bone healing and up to 3 to 4 months of swelling. So, planning is the most important aspect of scheduling a surgery. Many surgeons, including surgeons in our group, use absorbable pins to fix the Bunion. These absorbable pins do not need to be removed and thus may prevent the need for a second surgery to remove a screw or metallic implant. Schedule an appointment with your podiatrist to discuss the appropriate treatment for you.
Dr Rupley writes:
"For those patient wearing summer sandals or going barefoot, please take caution. Many of the painful lumps and bumps on the bottom of your feet can come from walking barefooted inside your home. Anything can become embedded into the thick sole of the foot and remain for months at a time. Some of our patients come in thinking that it is a plantar’s wart, but come to find out it is a foreign body, AKA a small piece of something that should not be there. Most of the time it is broken shards of glass from the kitchen. Other times, I have found small slivers of hair, beard, plastic, wire, thorns, etc. So if you have a painful lump, pay attention and seek treatment. Some of these go on to an infection that needs surgery or hospitalization. It is best to wear socks and shoes, even in your own home to reduce the risk."
Discussions about Diabetes and feet seem to harbor fear and worry about amputation and with good cause. There are some myths out there, however, that I need to clarify and shed some light on the matter. The truth of the matter is that Diabetes is progressive and tends to change with the amount of time you have been diagnosed with the condition. It also matters how well you’ve been taking care of your Diabetes and overall health. If your feet are normal and you’ve controlled your Diabetes well, then the risk of a non-traumatic amputation is the same as the non-Diabetic population. Meaning, you have the same risk as everyone else. If you develop numbness and circulation changes, the risk goes up quite a bit. So an annual foot examination is very important. Getting tested early is also very important if you are experiencing symptoms. The problem with Diabetes, most patients feel fine and do not have the classic symptoms. Hence, the disease progresses without the patient noticing. We think that most of the problems in the Diabetic foot are preventable. So early detection and treatment is the best approach. It surprises me to hear that patients wait several years before getting their feet checked.
This Blog was Written by: Dr Kathryne Rupley, DPM, FACFAS
The visible bump on the side of the foot, actually represents a deformation of the bony structure inside the foot. The term bunion usually indicates the big toe leans toward the second toe, and the first metatarsal bone (the bone right behind it) leans out. This causes the bump and the widening of the foot. Bunions are hereditary, and exacerbated by shoes. Severity of the bunion deformity is not based on the appearance, but based on the symptoms. Some will have a severe appearance to their bunion, and not have any pain. Others may have a mild appearing bunion, and have much difficulty with walking, standing, and all their shoes. Wider shoes and extra support for better joint function seem to help most, but some do not respond to this conservative treatment.
Surgical correction for bunions has come a long way and is quite successful. Today, bunion deformities can be corrected with outpatient surgery. Most bunions can be realigned with an osteotomy (bone cut) and absorbable pin fixation (the pin dissolves over time). Recovery could be as quick as six weeks without the need for crutches from day one. Consider having your bunion deformity evaluated by a Board Certified Podiatric Surgeon in your area.
Undergoing foot surgery can be made easier with a few small preparation tips. Following your doctors orders about weight bearing restrictions is probably the most important step to reduce your risk of complications. Another key area is preparation of your house and running errands before the surgery. Try to stock up on food items and necessary items to remain inside your home resting for at least the first one to two weeks. Don’t expect to be able to roam inside a large department store or go shopping for an extended amount of time. Choose a smaller convenience store with less walking involved if you must go out shopping.
Try not to start any major projects, home repairs, or moving heavy boxes or items after you have your surgery. Your doctor will let you know when your restrictions are lifted. In the meantime, use common sense when it comes to doing any activity that may require long distance walking or prolonged standing. Traveling for more than 2hours by car is also another concern. Let your family know that you will not be able to travel until your doctor advises you. If you have to get involved, ask yourself if this activity is worth the risk of a foot complication with your surgery. This will help make the decision easy.
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