Normal bunions have an outward deviation of about 10°, while bunions with an outward deviation of more than 15° are called bunions, also known as “big feet” in common parlance. After a bunion, the bones on the inside of the metatarsal head form and rub against the shoe, causing local redness, swelling and pain, which is called a bunion. In severe cases, skin breakdown and infection can occur. Because bunions are often accompanied by lesions in other parts of the foot, such as hammertoes, metatarsalgia, bursitis of the little toe, flat feet, etc., some people also call bunions bunion complex or bunion syndrome. Bunions occur in men and women at a ratio of 1:9 to 15, and there are various factors for their occurrence. For example, it is genetically related, with about 60% of bunion patients having a family history. Improperly fitted shoes are also a common cause of bunions. Other factors such as systemic diseases, foot deformities
Other conditions such as systemic diseases, foot deformities, foot trauma, etc. may cause bunions. The bunion is an important part of the foot structure. A bunion increases the load on the second toe and creates problems with the second toe. The second toe can squeeze the third toe and the third toe squeezes the fourth toe …… hence the deformity of the forefoot. A frequent problem with the second toe is pain under the second toe and a callus (callus) under the head of the second metatarsal that produces pain. In some people, the bunion deformity is not severe and there is no significant pain, but the weight-bearing structure of the foot is changed after the bunion, and the outward shift of the weight may produce deformity of the lateral toe and even necrosis of the metatarsal head. Therefore, the impact of bunions on the human body is very significant. Bunions are not a simple lesion. The diversity of different degrees of deformity and pathological changes as well as the different requirements of the patient give us a variety of options when treating bunions. The treatment of bunions can be divided into surgical and non-surgical treatments, which can be chosen according to your specific situation. In some older adults, the toe is deformed but not painful and can be left untreated. For some adolescents, the bunion will continue to worsen with growth and development, and measures should also be taken to stop the progression of the deformity, such as the use of orthotics. The goal of non-surgical treatment is to relieve local pressure and avoid the occurrence of pain. Treatment is to wear loose fat shoes or protect the bunion area with foot pads to avoid local pressure. Once bunions occur, physical therapy can be done and anti-inflammatory and pain medications can be used topically or taken. For some mild to moderate bunions, orthotics can be used to slow down the development of the deformity. If the deformity is severe, the pain is obvious, and it affects work and life more, surgery should be performed. In some young people, the deformity is not severe, but the deformity is likely to continue to develop, and surgery is also needed. Others have no obvious pain, but because the deformity is heavy and affects the aesthetics, they can also be surgically corrected. However, caution should be exercised in such cases. Although bunion surgery is not major, good results cannot be obtained if the surgical procedure is not properly selected or operated. Although there are more than 150 surgical methods available, there is still no one method that can solve all problems. In other words, one surgical approach cannot treat all bunion patients. How to choose an appropriate method is a problem that confuses the average orthopedic surgeon. The hand and foot surgeons at Dalian Orthopaedic Hospital develop the most suitable surgical plan for the patient through careful pre-surgical examination, special x-rays and plantar stress distribution measurements. The most advanced international surgical techniques are used. The surgery is done under local anesthesia, without preoperative water fasting, and the most suitable surgical method is selected according to the different pathological changes of the patient (each treatment method has its advantages and disadvantages, and only by understanding the characteristics of various surgical methods and combining them with specific patients can satisfactory results be obtained), such as the bony flab on the inner side of the metatarsal head of the bunion needs to be removed, and the adductor muscle that pulls the bunion outwardly deflected needs to be cut. The deformed metatarsal may have to be cut and fixed to a normal position. If the bunion joint has been destroyed, joint fusion or replacement surgery may be required. Other concomitant pathologies of the foot are addressed intraoperatively. The wound is closed only after fluoroscopy has reached a satisfactory position, which ensures the quality of the surgery. Due to the adoption of internal fixation, no plaster support is needed after surgery, and the patient can walk on the ground with postoperative shoes. It is greatly convenient for the patient. The new surgical approach results in less pain, more precise efficacy, faster recovery and fewer complications for the patient.