Bilateral Hallux Valgus In Children


Overview
Bunion Pain
The original definition of a bunion was a bursa (a fluid-filled sac) on the side of the foot near the base of the big toe. The bursa was caused by a chronic friction of the patient's first metatarsal bone (the bone to which the big toe attaches) and the shoe. Few people go by this definition any longer. Today most people consider a bunion to be the enlarged bone on the side of the foot that typically caused the bursa. Along with this bump, there is usually an associated mis-alignment of the big toe, with it leaning in towards the second toe. In medical jargon, the term for a bunion is "Hallux Abducto Valgus," or "HAV" for short. Though the condition is really slightly different, it may also be known as "Hallux Valgus." Bunions are usually a progressive problem, and can make it difficult to find shoes that fit. The condition is often quite uncomfortable, not only because of the pressure the shoes exert on the bump, but because of the other factors associated with bunions, which we shall discuss shortly. This is usually a progressive problem, and can make it difficult to find shoes that fit. The condition is often quite uncomfortable, not only because of the pressure the shoes exert on the bump, but because of the other factors associated with bunions, which we shall discuss shortly.

Causes
People born with abnormal bones (congenital) in their feet. Inherited foot type. Foot injuries. Inflammatory or degenerative arthritis causing the protective cartilage that covers your big toe joint to deteriorate. Wearing high heels forces your toes into the front of your shoes, often crowding your toes. Wearing shoes that are too tight, too narrow or too pointed are more susceptible to bunions. Pain from arthritis may change the way you walk, making you more susceptible to bunions. Occupation that puts extra stress on your feet or job that requires you to wear ill-fitting shoes. The tendency to develop bunions may be present because of an inherited structural foot defect.
SymptomsThe most common symptoms associated with this condition are pain on the side of the foot. Shoes will typically aggravate bunions. Stiff leather shoes or shoes with a tapered toe box are the prime offenders. This is why bunion pain is most common in women whose shoes have a pointed toe box. The bunion site will often be slightly swollen and red from the constant rubbing and irritation of a shoe. Occasionally, corns can develop between the 1st and 2nd toe from the pressure the toes rubbing against each other. On rare occasions, the joint itself can be acutely inflamed from the development of a sac of fluid over the bunion called a bursa. This is designed to protect and cushion the bone. However, it can become acutely inflamed, a condition referred to as bursitis.

Diagnosis
Your doctor will be able to diagnose a bunion by asking about your symptoms and examining your feet. You may also have blood tests to rule out any other medical conditions, such as rheumatoid arthritis or gout, although this is rare. Your doctor may refer you to a podiatrist or chiropodist (healthcare professionals who specialise in conditions that affect the feet).

Non Surgical Treatment
Bunions are progressive problems, meaning they tend to get worse over time. Sometimes severe-looking bunions don't hurt much, and sometimes relatively modest-looking bunions hurt a great deal. Thus, treatment varies depending upon a patient's symptoms. You can often improve the discomfort of bump pain by a change to more proper shoes. Alternatively, alterations to existing shoes may improve pain associated with bunions. Accommodative padding, shields and various over-the-counter and custom-made orthopaedic appliances can also alleviate bunion pain. Anti-inflammatory medications, steroid injections, physiotherapy, massage, stretching, acupuncture and other conservative treatment options may be recommended by your podiatric physician to calm down an acutely painful bunion. Long term, orthoses (orthotics) can address many of the mechanical causes of a bunion. Thus, while orthoses don't actually correct a bunion deformity, if properly designed and made, they can slow the progression of bunions. They can also be made to redistribute weight away from pain in the ball of the foot, which often accompanies bunion development. Padding, latex moulds and other accommodative devices may also be effective. While they don't correct the misalignment in the bones, they may alleviate pain. Often, though, when conservative measures fail to alleviate pain associated with the bunion, when you start to limit the types of activities you perform, when it's difficult to find comfortable shoes, and when arthritis changes how you walk, surgery may be the best alternative.
Bunions Callous

Surgical Treatment
There are many different procedures described to correct bunions. You should be aware that usually just shaving the bunion off, although it is attractive and minimally invasive, is usually not enough. Initially the foot will look much better but with time the bunion will recur. Arthrodesis refers to surgery performed on the great toe joint where the joint is fused. This is usually reserved for people with very severe deformities when other surgical options are impossible. Bunionectomy refers to the simple removal of the bunion itself. This is seldom used because it doesn?t correct the underlying bone problems. Osteomety is the commonest surgical procedure. The bone is cut and the bones realigned and pinned in place until they heal so that the underlying bone deformity is corrected and the bunion will not recur. The resection arstplasty refers to the removal of the toe joint and this creates a flexible scar that functions as the joint instead. In the past there has been some interest in implanting artificial joints but this has fallen out of favor due to the fact that they usually do not hold up with the normal every day stress that people put their feet through.

tag : Bunions

 
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