The causes of bunions: bunion deformities are more common in women, with a male to female ratio of about 1:40. There are many causes of bunions, about half of which are related to genetic factors, and children of mothers with bunions are significantly more likely to have them. Since women have weaker ligaments in their feet than men, they are more likely to develop bunions under the same genetic conditions. In addition, the flexibility of the ligaments decreases with age, which is why bunions are more common in middle-aged and older women. Other common causes of bunions are.
1. Shoe wearing habits. Women often wear high-heeled shoes, pointed shoes, the whole body weight is easily concentrated in the front of the foot, pointed shoes often force the forefoot forced squeezed in a narrow triangular area, so that the toes in a long-term abnormal state, in the long run will gradually form bunion deformity.
2, the bunion, the first metatarsal, the medial cuneiform bone where the first metatarsal column increased mobility.
3. Abnormal foot structure. The common one is flat foot, and other structural abnormalities include over-length of the first metatarsal, inversion of the first metatarsal, and bunion rotation front deformity, etc.
4, joint inflammation. Rheumatoid arthritis, gout and other pathologies often destroy the normal balance structure of the soft tissues and bone joints of the foot, resulting in bunion deformity by the combined effect of various internal and external factors.
5.Other. Trauma, cerebral palsy and other causes of neuromuscular lesions often cause imbalance in the soft tissue muscles of the foot, especially the first metatarsophalangeal joint, which can also produce bunions.
Clinical manifestations of bunions: Pain is the main symptom of bunions, and the presence of bunion deformity and painful medial bunions of the first metatarsophalangeal joint are the main clinical manifestations. However, the degree of deformity is not directly proportional to the pain, and pain is not necessarily present when the deformity is obvious. In addition to pain caused by bunions, other signs such as hammertoes of the second and third toes and plantar callus are also important in producing painful symptoms. The x-ray presentation varies with the severity of the disease.
Pain.
1. pain caused by bunions.
2, pain caused by hammertoe.
3, pain caused by plantar callus.
4, pain caused by stress concentration in the lateral metatarsals.
5.Pain caused by postural substitution in the knee, hip and lumbosacral region.
Deformity: bunion, inversion of the first metatarsal, medial osteochondrosis of the first metatarsophalangeal joint, hammertoe of the second and third toes, etc.
X-ray: the first metatarsophalangeal joint is semi-dislocated, the bunion is displaced to the midline, the bunion angle is >15 degrees, and the angle between the first and second metatarsals is >10 degrees as the basic manifestation.
According to the clinical manifestations and X-ray changes, the development of bunion can be divided into three stages.
Early stage: symptoms are mild, pain is not serious, and there is no subluxation of the first metatarsophalangeal joint on X-ray.
Middle stage: bunion deformity is obvious, bunion pain is more severe, and the x-ray shows a lateral subluxation of the proximal phalangeal joint of the bunion and a hammer-shaped deformity of the second toe.
Late stage: In addition to bunion pain, the metatarsophalangeal joint is swollen and painful, and osteoarthritis is seen in the metatarsophalangeal joint on X-ray.
Treatment of bunion: conservative treatment and surgical treatment.
Conservative treatment: Only applicable to early stage patients.
1. Non-specific treatment: rest, reducing activities and wearing loose shoes can reduce the pain. Topical drugs such as fotarine can be applied locally when pain is present, or non-steroidal anti-inflammatory and analgesic drugs such as Cilazol can be taken orally. Hot compresses and physical therapy are also effective. Sometimes local closure of the painful area is also possible. However, most conservative treatments are symptomatic but not causative, and cannot fundamentally relieve pain, and are prone to relapse after a period of time.
2.Wearing orthopedic brace: There are many kinds of braces for bunion correction, and different types and degrees of bunions need different types of braces. Usually wear braces at night and insist on 8 hours a day for 3 months, which can reduce the pain symptoms to some extent and slow down the development of further deformation of the bunion.
Surgery: Once a bunion causes persistent pain or severe deformity, surgery is required. Surgery can reduce the pain and correct the deformity to improve the function of the foot. Purpose of surgery: The primary purpose is to relieve pain. Treatment goals.
1. correction of the bunion deformity.
2.Removal of hyperplastic bones and bursa.
3.correction of the first metatarsal inversion and repositioning of the seed bone system.
4.Adjustment of metatarsal head weight-bearing and correction of combined deformities (callus, hammertoe, etc.).
5.Stabilize the first metatarsal row.
The surgical treatment itself is less invasive, and surgery can be considered for those with severe pain. There are many surgical methods, and the appropriate method should be chosen according to the degree of deformity. In addition, the surgery is very skillful, and if the operation is not fine it will affect the overall efficacy, therefore, it is important to choose an experienced surgeon.