Hallux valgus is a painful deformity of the great toe joint which is referred to as a bunion. Bunion’s affect the first metatarsophalangeal (MTP) joint in which there is an angular deformity of the first metatarsal bone which causes a painful bump on the inside or top of the foot. Tailor’s bunion is a similar deformity that is seen on the small toe or the outside of the foot.
Causes:
The causes stem from congenital predisposition with a 9:1 prevalence in females vs males. It is not the bunion that is directly inherited but more of the foot deformity causing the bunion secondarily. Many have drawn links between the formation of hallux valgus and the presence of other foot/ankle abnormalities.These include flatfoot deformity, hypermobility of the first ray, equinus contracture, and hindfoot deformity secondary to rheumatoid arthritis or posterior tibial tendon dysfunction.
Symptoms:
Pain in hallux valgus typically stems from one of four origins: the medial eminence of the bunion also known as bump pain. The MTP joint pain which can present with burning or numbness due to stiffness. The lesser metatarsal pain due to inability of the great toe joint to help during propulsion, and sesamoid bone pain due malalignment. Pain symptoms associated with a tailor’s bunion is due to bump pain with shoewear when walking.
Diagnosis:
Is based on a history and physical exam of your symptoms. A biomechanical gait analysis is also evaluated by the foot and ankle surgeon. Imaging studies may also be incorporated by the foot and ankle surgeon to further help determine the severity of the condition.
Treatment:
Conservative treatment options consist of:
Custom orthotic devices
Activity modifications
Surgical treatment options are also available when the conservative treatment options fail to improve long term pain symptoms and the bunion starts to impact daily lifestyle activities. You and the foot and ankle surgeon can decide if surgical correction is best for you. A vast variety of surgical procedures are available to treat the many types of bunions. The foot and ankle surgeon will discuss which procedures would best address your bunion and or tailor’s bunion deformity.