Is This a Bunion?

    Hardly a day goes by in my clinic without a patient asking me "is this a bunion".  First lets start with what a bunion is in doctor speak.  A bunion is an increase in the angle between the first and second metatarsal and it may be accompanied by a deviation of the hallux.  Wow! That's a really fancy way to say your big toe is heading toward the little toe and you have a bump on the inside of your foot.  This may be a bit of an over simplification but I think you get the picture. 

     The next question to follow is usually "what should I do about it"?  My answer is always the same "does it hurt"?  If it does not hurt I am not a big believer in doing anything.  However it the foot hurts the patient and doctor must have a conversation concerning the the treatment options.  If the pain is deep within the joint there is a possiblilty the pain can be controlled with a custom orthotic.  If the pain is a result of the bone hitting the shoe or the toes hitting each other surgery may be indicated.  

     Once we begin to have a conversation about surgery we need to discuss what exactly the surgical options are and equally as important what they are not.  I always begin by asking what the patient does for a living. The recovery course as far as demands placed on the foot will differ for those who are seated at work vs. those who are on their feet. This is a critical consideration as we don't want to jeopardize your surgery.  

     The severity of the bunion deformity will determine what surgical procedures the patient is a candidate for.  There are literally dozens of procedures that can be used to correct a bunion deformity.  Some allow the patient to return to weight bearing within a few days of surgery while others require you to be off your feet for 6-8 weeks.  Obviously those are two very different post op courses. 

     When deciding with your foot and ankle surgeon which procedure is best for you consider the following:  1. What are the demands going to be on me post op?  2. When will I be able to go back to work? 3. If I can't walk on my foot how will I get around?  These are just a few of the questions that need to be answered.  

     The advice I give my patients is this, be honest with yourself as far as your abilities to get around and most importantly think about long term.  I am always amazed by the numer of patients I see who have had bunion surgery prior to coming to see me are wondering "how did it come back"?  I find that usually while discussing surgical options these patients were told what they wanted to hear and not what they needed to know. 

     If you believe you have a bunion deformity please come see myself or any of our doctors at Cambridge Foot and Ankle in our Orange or Newport Beach office and we will be happy to review your case with you and discuss the options for your "bunion".  

Author
Dr. H. Austin Hewlett Dr. Hewlett is Board Certified in both Foot and Reconstructive Rear Foot Surgery by the American Board of Foot and Ankle Surgeons. The highest certification in the field of Podiatry. He has been practicing at Cambridge Foot and Ankle Associates for 18 years and is also the longest sitting Podiatrist on the Orthopedic Executive Committee at Saint Josephs Hospital in Orange Ca. In addition Dr. Hewlett serves as the director of the Sports Medicine Fellowship at Specialty Surgical Center of Irvine. He has been surfing for over 40 years and absolutely loves raising his daughter. Dr. Hewlett is available for consultation in both the Orange and Newport Beach offices of Cambridge Foot and Ankle. He specializes in all treatment aspects of the foot and ankle ranging from skin infections to complicated reconstructive surgery of the foot and ankle.

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