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20-September-2008 10:21:21 - Bunion Bunion Classification and external resources ICD-10 M20.1 ICD-9 727.1 DiseasesDB 5604 eMedicine orthoped/467 MeSH D006215 Hallux valgus Hallux valgus A bunion hallux valgus is a structural deformity of the bones and the joint between the foot and big toe, and may be painful.1 A bunion is an enlargement of bone or tissue around the joint at the base of the big toe metatarsophalangeal joint. The big toe may turn in toward the second toe angulation, and the tissues surrounding the joint may be swollen and tender. Today the term usually is used to refer to the pathological bump on the side of the great toe joint. The bump is the swollen bursal sac and/or an osseous bony deformity that has grown on the mesophalangeal joint where the first metatarsal bone and hallux meet. Contents 1 Medical terms 2 Symptoms 3 Formation/development 4 Treatment 4.1 Orthotics 4.2 Surgery 5 See also 6 References 7 External links Medical terms The term hallux valgus or hallux abducto valgus are the most commonly-used medical terms associated with a bunion deformity, where hallux refers to the great toe, valgus refers to the abnormal angulation of the great toe commonly associated with bunion deformities, and abducto refers to the abnormal drifting or inward leaning of the great toe towards the second toe, which is also commonly associated with bunion disorders. Symptoms The symptoms of bunions include irritated skin around the bunion, joint redness and pain, and possible shift of the big toe toward the other toes. Formation/development Bunions are caused by a biomechanical abnormality, where certain tendons, ligaments, and supportive structures of the first metatarsal are no longer functioning correctly. This biomechanical abnormality may be caused by a variety of conditions intrinsic to the structure of the foot--such as flat feet, excessive ligamentous flexibility, abnormal bone structure, and certain neurological conditions. These factors are often considered genetic. Although no experts are convinced that poor fitting footwear is the main cause of bunion formation 1, other sources concede only that footwear exacerbates the problem caused by the original genetic deformity. 2 Bunions are commonly associated with a deviated position of the big toe toward the second toe; and the deviation in the angle between the first and second metatarsal bones of the foot. The small sesamoid bones found beneath the first metatarsal which help the flexor tendon bend the big toe downwards may also become deviated over time as the first metatarsal bone drifts away from its normal position. Arthritis of the great toe joint, diminished and/or altered range of motion, and discomfort with pressure applied to the bump or with motion of the joint, may all accompany bunion development. Treatment Bunions may be treated conservatively with changes in shoe gear, different orthotics accommodative padding and shielding, rest, ice, and medications. These sorts of treatments address symptoms more than they correct the actual deformity. Surgery, by a Podiatrist, may be necessary if discomfort is severe enough or when correction of the deformity is desired. Orthotics Orthotics are bunion cushions, splints, regulators while conservative measures include various footwear like gelled toe spacers, bunion / toes separators, bunion regulators, bunion splints, and bunion cushions. Surgery Procedures are designed and chosen to correct a variety of pathologies that may be associated with the bunion. For instance, procedures may address some combination of: removing the abnormal bony enlargement of the first metatarsal, realigning the first metatarsal bone relative to the adjacent metatarsal bone, straightening the great toe relative to the first metatarsal and adjacent toes, realigning the cartilagenous surfaces of the great toe joint, addressing arthritic changes associated with the great toe joint, repositioning the sesamoid bones beneath the first metatarsal bone, shortening, lengthening, raising, or lowering the first metatarsal bone, and correcting any abnormal bowing or misalignment within the great toe. The age, health, lifestyle, and activity level of the patient may also play a role in the choice of procedure. Bunion surgery can be performed under local, spinal, or general anesthetic. The trend has moved strongly towards using the less invasive local anesthesia over the years. A patient can expect a 6- to 8-week recovery period during which crutches are usually required for aid in mobility. It is much less common today as newer, more stable procedures and better forms of fixation stabilizing the bone with screws and other hardware are used. See also Foot Podiatry Tailor's bunion bunionette References ^ American College of Foot and Ankle Surgeons. Bunions. Retrieved on 2008-03-05. External links Textbook of Hallux Valgus and Forefoot Surgery, complete text online in PDF files BunionCusions.com, Various Bunion Remedies v d e Diseases of the musculoskeletal system and connective tissue M, 710-739 Arthropathies Arthritis Septic arthritis - Reactive arthritis - Rheumatoid arthritis - Psoriatic arthritis - Felty syndrome - Juvenile idiopathic arthritis - Still's disease - crystal Gout, Chondrocalcinosis - Osteoarthritis Heberden's node, Bouchard's nodes - Monoarthritis/Polyarthritis Specific joints shoulder Winged scapula - elbow Cubitus valgus, Cubitus varus - hand Wrist drop, Boutonniere deformity, Swan neck deformity hip Protrusio acetabuli, Coxa valga, Coxa vara - leg Foot drop, Flat feet, Club foot, Unequal leg length - patella Luxating patella, Chondromalacia patellae - foot Bunion/hallux valgus, Hallux varus, Hallux rigidus, Hammer toe general terms Valgus deformity, Varus deformity Other Hemarthrosis - Arthralgia - Osteophyte - Hypermobility Systemic CT disorders vasculitis: Arteritis Polyarteritis nodosa, Takayasu's arteritis, Temporal arteritis - arterioles/capillaries Wegener's granulomatosis, Kawasaki disease, Churg-Strauss syndrome, Microscopic polyangiitis hypersensitivity/autoimmune: Hypersensitivity vasculitis - Goodpasture's syndrome - Systemic lupus erythematosus Drug-induced - Dermatomyositis Juvenile dermatomyositis - Polymyositis - Scleroderma - Sjögren's syndrome - Behçet's disease - Polymyalgia rheumatica - Eosinophilic fasciitis Dorsopathies spinal curvature Kyphosis, Lordosis, Scoliosis - Scheuermann's disease - Spondylolysis - Torticollis - Spondylolisthesis Spondylopathies Ankylosing spondylitis, Spondylosis, Spinal stenosis - Schmorl's nodes - Degenerative disc disease - Coccydynia - Back pain Radiculopathy, Neck pain, Sciatica, Low back pain Soft tissue disorders Muscle Myositis Pyomyositis - Myositis ossificans Fibrodysplasia ossificans progressiva Synovium and tendon Synovitis/Tenosynovitis Calcific tendinitis, Stenosing tenosynovitis, Trigger finger, DeQuervain's syndrome - Irritable hip - Ganglion cyst Bursa Bursitis Olecranon, Prepatellar, Trochanteric - Baker's cyst Fascia/fibroblastic Fasciitis Plantar fasciitis, Nodular fasciitis, Necrotizing fasciitis - Dupuytren's contracture - Fibromatosis Shoulder lesions Adhesive capsulitis - Rotator cuff tear - Subacromial bursitis Enthesis Enthesopathies Iliotibial band syndrome, Achilles tendinitis, Patellar tendinitis, Golfer's elbow, Tennis elbow, Metatarsalgia, Bone spur, Tendinitis Other, NEC Muscle weakness - Rheumatism - Myalgia - Neuralgia - Neuritis - Panniculitis - Fibromyalgia Osteopathies disorders of bone density and structure: Osteoporosis - Osteomalacia - continuity of bone Pseudarthrosis, Stress fracture - Monostotic fibrous dysplasia - Skeletal fluorosis - Aneurysmal bone cyst - Hyperostosis - Osteosclerosis Osteomyelitis - Avascular necrosis - Paget's disease of bone - Algoneurodystrophy - Osteolysis - Infantile cortical hyperostosis Chondropathies Juvenile osteochondrosis Legg-Calvé-Perthes syndrome, Osgood-Schlatter disease, Köhler disease, Sever's disease - Osteochondritis - Tietze's syndrome - Relapsing polychondritis See also congenital Retrieved from http://en..org/wiki/Bunion Categories: Foot | Orthopedics Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Español Euskara Français Italiano Nederlands 日本語 Norsk bokmål Polski Português Suomi Svenska This page was last modified on 17 August 2008, at 22:51
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