Bunions
and Hammertoes, the bread and butter of Podiatry
I have written in a previous blog about bunions and
hammertoes, but because this is such an important part of what I do and see on
a daily basis I thought it would be a good idea to revisit it. Many patients
not only present with a bunion but with a hammertoe of the adjacent toe.
What
exactly is a bunion and a hammertoe?
A bunion, or better known medically
speaking as Hallux Abducto Valgus Deformity (HAV), is a bony deformity of the foot that tends to worsen over
time. A bunion is a deviation of the big toe and the associated metatarsal
bone. It occurs when the big toe drifts over to the lesser toes and causes what
appears to be “a bump” on the side of the feet. A hammertoe is when a toe
starts to curl and may appear to be dislocated at the knuckles of the toe. Typically,
as a bunion worsens and moves over it will push against a hammertoe thus making
it worse.
Who gets a bunion and hammertoes?
It is difficult to
predict who will get a bunion. It can be seen in a wide array of people
including young teenagers, middle aged individuals and seniors. The causes of a
bunion are debated within the medical community but it seems to be caused by
many different factors including genetics, flatfeet and tight shoe gear. When a
hammertoe is associated with a bunion, the bunion is usually the cause of the
hammertoe. When there are hammertoes of all the toes, and no bunion deformity,
it is usually due to significantly high arched feet.
How can one treat bunions and hammertoes?
There foot deformities
are usually first treated conservatively. Bunion splints, toe spacers,
hammertoe crests, ice, wider shoes, appropriate orthotics and medication can
help treat these painful deformities. Conservative treatment is successful most
of the time to prevent surgical intervention. These treatment modalities are
usually all that is necessary, but in some circumstances surgical intervention
is warranted.
What does this type of surgery entail?
There is a wide array
of different types of surgeries to correct the deformities. Your surgeon will
determine which type of surgery to perform based on your symptoms, age, x-rays
of your feet, level of activity etc. Once the surgeon takes all these factors
into account she will let you know if you will have hardware placed in the foot
to help correct the deformity. Surgery
does require anesthesia and is usually performed in an operating room under the
surveillance of an anesthesiologist.
Depending on what type
of surgery you have the recovery can range from 2-8 weeks with the use of
crutches or walker. The type of surgery performed will dictate the type of
weight bearing that is allowed. 2 months post operatively one may begin to return
to regular shoe gear. After surgery it is highly recommended to wear custom
orthotics long term to prevent re-occurrence of the deformity.
For more information,
please visit http://www.footnj.com/podiatrist-new-jersey-about-us/23/234-hammertoes
