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{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
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{{CMG}}
{{SK}} Hallux valgus
==[[Bunion overview|Overview]]==


'''Associate Editor-In-Chief:''' {{CZ}}
==[[Bunion pathophysiology|Pathophysiology]]==


{{Editor Join}}
==[[Bunion causes|Causes]]==


==Overview==
==[[Bunion differential diagnosis|Differentiating Bunion from other Diseases]]==


A '''bunion''' ('''hallux valgus''') is a sometimes painful structural deformity of the bones and the [[joint]] between the foot and big toe.
==[[Bunion epidemiology and demographics|Epidemiology and Demographics]]==


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 (displacement), and the tissues surrounding the joint may be swollen and tender.
==[[Bunion risk factors|Risk Factors]]==


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).
==[[Bunion natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Medical terms==
==Diagnosis==
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 deformity|valgus]]" refers to the abnormal rotation 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.
[[Bunion history and symptoms|History and Symptoms]] | [[Bunion physical examination|Physical Examination]] | [[Bunion laboratory findings|Laboratory Findings]] | [[Bunion x ray|X Ray]]
 
==Symptoms==
The symptoms of bunions include swelling of the [[metatarsophalangeal joint]], irritated skin around the bunion, joint redness and pain, and possible shift of the big toe toward the other toes.
 
==Bunion formation/development==
Bunions are caused by a biomechanical abnormality, where certain [[tendon]]s, [[ligament]]s, 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 [[Genetics|genetic]].
 
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.
 
Although wearing shoes that crowd the toes does not cause bunions to form, it sometimes makes the existing deformity progressively worsen and symptoms may arise
sooner. [http://www.footphysicians.com/footankleinfo/bunions.htm]


==Treatment==
==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 may be necessary if discomfort is severe enough or when correction of the deformity is desired.
[[Bunion physical therapy|Physical Therapy]] | [[Bunion surgery|Surgery]] | [[Bunion cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Bunion future or investigational therapies|Future or Investigational Therapies]]
===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 [[arthritis|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.
==Case Studies==
:[[Bunion case study one|Case #1]]


===Orthotics: bunion cushions, splints, regulators===
==Related Chapters==
Other measures include various footwear like gelled toe spacers, bunion / toes separators, bunion regulators, bunion splints, and bunion cushions
 
==See also==
*[[Foot]]
*[[Foot]]
*[[Podiatry]]
*[[Podiatry]]


{{Diseases of the musculoskeletal system and connective tissue}}
{{Diseases of the musculoskeletal system and connective tissue}}
{{SIB}}
 


[[Category:Foot]]
[[Category:Foot]]
[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Skeletal disorders]]
[[Category:Rheumatology]]
[[Category:Rheumatology]]
[[Category:Overview complete]]





Latest revision as of 21:21, 15 November 2012

For patient information click here

Bunion
ICD-10 M20.1
ICD-9 727.1
DiseasesDB 5604

Bunion Microchapters

Home

Patient Information

Overview

Pathophysiology

Causes

Differentiating Bunion from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

Treatment

Physical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Bunion On the Web

Most recent articles

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All Images
X-rays
Echo & Ultrasound
CT Images
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Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Bunion

CDC on Bunion

Bunion in the news

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Directions to Hospitals Treating Bunion

Risk calculators and risk factors for Bunion

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and keywords: Hallux valgus

Overview

Pathophysiology

Causes

Differentiating Bunion from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray

Treatment

Physical Therapy | Surgery | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

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