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Bunions and Claw toes - Orthopaedic Associates...

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Bunions and Claw toes A bunion is a lump on the side of the foot involving the main joint of the big toe (the 1 st MTP joint). It is usually caused by a deformity of this joint called Hallux Valgus (big toe deviating away from the midline) The cause is partly genetic and partly related to pointy shoes and high heels. This explains why the condition is more common in women. There are no non surgical ways to permanently correct the deformity but an orthotist or podiatrist should be able to provide you with a bunion splint which may alleviate your symptoms. HVA(hallux valgus angle) IMA (Inter metatarsal angle)
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Page 1: Bunions and Claw toes - Orthopaedic Associates Melbourneorthoam.com.au/wp-content/uploads/2018/02/dg-bunions-and-secon… · Bunions and Claw toes A bunion is a lump on the side of

BunionsandClawtoesAbunionisalumponthesideofthefootinvolvingthemainjointofthebigtoe(the1stMTPjoint).ItisusuallycausedbyadeformityofthisjointcalledHalluxValgus(bigtoedeviatingawayfromthemidline)

Thecauseispartlygeneticandpartlyrelatedtopointyshoesandhighheels.Thisexplainswhytheconditionismorecommoninwomen.Therearenononsurgicalwaystopermanentlycorrectthedeformitybutanorthotistorpodiatristshouldbeabletoprovideyouwithabunionsplintwhichmayalleviateyoursymptoms.

HVA(halluxvalgusangle)

IMA(Intermetatarsalangle)

Page 2: Bunions and Claw toes - Orthopaedic Associates Melbourneorthoam.com.au/wp-content/uploads/2018/02/dg-bunions-and-secon… · Bunions and Claw toes A bunion is a lump on the side of

Surgeryshouldbeconsideredfor:PainDifficultywithfootwearOrifyounoticethatthebunionisgettingworse(progressivedeformity)Therearemanyoperationsdescribedforhalluxvalgus.Theaimistocorrectboththe:

1. Intermetatarsalangle(IMA)2. HalluxValgusangle(HVA)

Oneexampleisthescarfosteotomywithsofttissuecorrection.Thescarfshapeisderivedfromthecarpentryindustryandprovidesastablemethodofcuttingtheboneandtranslatingitbeforefixingitwithscrews.Theintermetatarsalangleiscorrectedthisway.Thesofttissuereleasecorrectsthehalluxvalgusanglebyreleasingtightstructuresbetweenthefirstandsecondtoesandtighteningthecapsuleoverthesiteofthebunion.

FollowingsurgeryyoucanexpecttostayforonenightinhospitalItisimportanttospendthefirsttwoweekswiththefootstrictlyelevatedabovethelevelofyourheartfor23hoursaday.Awoundcheckisperformedatthe2weekscheckYouwillneedtowalkinastiffsoleopentoeshoeforabout6weeks.Anxrayisthenperformedtoconfirmthatrecoveryisoccurringasplanned.

Page 3: Bunions and Claw toes - Orthopaedic Associates Melbourneorthoam.com.au/wp-content/uploads/2018/02/dg-bunions-and-secon… · Bunions and Claw toes A bunion is a lump on the side of

Work(thesetimeframesarespeculativeonly):Sittingdutiesat3weeksaftersurgeryStandingdutiesindoors3weeks-2monthsaftersurgeryOutdoorduties–2monthsaftersurgeryReturningtodrivingisnotastraightforwardquestion.TheremaybeinsuranceimplicationswhichneedtobecheckedItdependsonwhichfootundergoessurgeryandwhetherthecarismanualorautomaticYoumustfeelconfidenttousethebrakeinanemergencysituation.Thereareanumberofpossiblecomplicationsthatcanoccurfrombunionsurgery.Someoftheseinclude:Longtermpainandswelling–upto12monthsRecurrenceofthebunionNumbnessandincreasedsensitivityaroundthesiteofthesurgeryStiffnessinthebigtoe

Page 4: Bunions and Claw toes - Orthopaedic Associates Melbourneorthoam.com.au/wp-content/uploads/2018/02/dg-bunions-and-secon… · Bunions and Claw toes A bunion is a lump on the side of

Clawingofthesecondtoeisarelativelycommoncondition.ItisoftenseentogetherwithabunionbecausethereisabiomechanicalassociationbetweenthemItcausespainfromrubbingonknuckleonthetopofthetoewithfootwearandtherecanalsobeapainfulprominenceofthemetatarsalheadonthesoleofthefoot.

ItmeansthatthesecondMTP(metatarsophalangealjoint)haswornoutandthereisnowanimbalanceofthemusclespullingonthetoe.Apodiatristororthotistmaybeabletoassistwithtoestraighteningdevicesoradvisingoradjustingfootwear.SurgerytostraightenthetoemayrequireafusionofthePIPjointwheretheknuckleis.Thismaymeanapininsertedinyourtoethatwouldneedtoberemoved6weeksaftersurgeryduringavisittotheconsultingrooms.Followingsurgerythetoeisusuallyshorterbutstraighter.Possibleproblemswithsecondtoestraighteninginclude12monthgsofpainandswellingRecurrenceoftheproblemSensitivityandnumbnessaroundthetoe

Sitesofpain


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