Bunion is a foot deformity in which the bunion is deflected outward beyond the physiological angle, and is one of the most common diseases of the forefoot, commonly known as “bigfoot”. It is generally diagnosed when the angle between the proximal phalanx of the bunion and the first metatarsal is greater than 15°, and the angle between the first and second metatarsals is greater than 10°. The etiology is genetic, shoe wear, flat feet, abnormal 1st metatarsal length, trauma, and systemic disease.
The main reason for treating bunions is to relieve the pain so that the patient can wear normal shoes and walk normally. Bunion pain arises from acute bunions due to pressure and friction after the medial bulge of the bunion head. More serious is the long-term abnormality of the bunion metatarsal joint, which will develop osteoarthritis causing pain and leading to dislocation of the second metatarsophalangeal joint.
Non-surgical treatment may temporarily reduce pain but will not delay the worsening of the deformity.
For most of the more severe bunions, surgery is the primary treatment.
The main pathological changes of bunion are.
1, bunion valgus and rotation
2. Medial bunion of the 1st metatarsal head
3, bunion
4.Imbalance of muscle strength around the 1st metatarsophalangeal joint
5.IMA enlargement
6.Dislocation of the metatarsophalangeal joint
7.DMAA enlargement
8.DASA enlargement
9.Metatarsal inversion
10.Metatarsal cuneiform joint instability
11.Metatarsophalangeal joint osteoarthritis
12, lateral toe changes, such as crossed toes, hammer toes, mallet toes, claw toes, bursitis of the little toe
Bunion is a progressive development of foot disease, when the deformity is found, timely diagnosis and treatment is necessary to avoid the development from mild to moderate bunion to severe bunion, which has to use complex treatment.
According to the patient’s specific situation, personalized surgical treatment is chosen with little trauma and early functional recovery of the patient:.
1. For mild and moderate bunions, the minimally invasive small incision Chevron procedure and Akin procedure are chosen, and patients can be on the ground the next day after surgery.
2. For severe bunions, Scarf, Ludloff, and Juvara procedures are chosen.
3. For bunions with instability of the medial metatarsal cuneiform joint, Lapidus procedure is chosen.