Evaluating a Bunion

Evaluation of the condition we commonly call a 'bunion' is a rather complex process most podiatric physicians perform routinely. Many patients will present to the clinic with complaints of pain or pressure from "the bump on the inside of my foot." Of course, they will often call it a bump, bunion, or spur, but I have not yet had any patients present themselves complaining of their "hallux abducto-valgus deformity." Yet immediately, as a foot and ankle surgeon, I translate the "bump" into a triplane orthopedic deformity having osseous and soft tissue components and involving four separate bones. Interesting how quickly that happens when you think about it.

In the course of evaluation, clinical aspects such as how large the prominence is, how painful it is to pressure and movement, the tendency to track with range of motion, the extent and quality of motion, the amount of instability at adjacent joints, and secondary anomalies such as sub second metatarsal tyloma are noted. Plain-film radiographs are certainly a routine part of the complete examination, and will include the obligatory 3-projection series: dorsoplantar, medial oblique, and lateral images. From these projections, we define angulational values and make note of other anomalies such as degenerative joint changes, articular flattening, bone stock and width, and any adjacent conditions that may contribute to the deformity or require attention in the course of any corrective procedures.

Treatment options include bunion splint's, orthotics, anti-inflammatory medications, Cortizone injections, shoe gear modification,  and surgery as a last resort.

There are over 300,000 bunion operations performed in this country and overall it's a very successful way of helping with the deformity .

Surgery does require three weeks of wearing a boot but does not require any non weight bearing which used to be required in the past with older surgical procedures.

Central Florida Foot & Ankle Center, LLC 101 6th Street N.W. Winter Haven, FL 33881 Phone: 863-299-4551 http://www.FLFootandAnkle.com