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Hallux Abducto Valgus

Overview
Bunions
A bunion is an abnormal bump, or bony enlargement that forms at the base of your big toe. In the early stages, the bunion may be small and the side of your foot may be slightly swollen. As it progresses, the bump gets larger and becomes increasingly painful. Your big toe may point towards your other toes, rather than straight. Shoes may be uncomfortable to wear and add to the irritation of the joint.


Causes
Women traditionally have a higher rate of bunions, which is to be expected, since it is they who have traditionally worn shoes with high heels, a narrow toe box, or whatever fashion dictates from year to year. However, men can suffer from bunions as well, as can anyone for whom the right (or wrong) conditions exist, poor foot mechanics, improper footwear, occupational hazards, health and genetic predisposition. Finally, bunions have long been a condition associated with the elderly, and although they often appear in conjunction with inflammatory joint diseases such as arthritis (which is often associated with age), they can strike at any point in life, including adolescence.


Symptoms
The major symptom of bunions is a hard bump on the outside edge of the foot or at the base of the big toe. Redness, pain and swelling surrounding or at the MTP joint can also occur.


Diagnosis
X-rays are the best way to determine the amount of deformity of the MTP joint. Blood work may be required to rule out other diseases that may be associated with bunions such as rheumatoid arthritis. Other tests such as bone scans or MRI’s are not usually required.


Non Surgical Treatment
There are a number of treatment options for bunions. Non-surgical treatments are usually tried first, including painkillers, orthotics (insoles) and bunion pads. However, these can only help to reduce the symptoms of bunions, such as pain. They don’t improve the appearance of your foot.
Bunions Callous


Surgical Treatment
The decision on bunion operative treatment is usually made on the basis of the level of pain and inconvenience caused by the bunion or second toe. There is no correct answer to the question, bunion pain and inconvenience are both highly subjective. An inability to get into a formal shoe may be a major problem for a business woman or man but no problem at all for someone wearing trainers every day. However in general if a bunion is free of pain then the recommendation would not be for surgery. That said, this is not an absolute. Once a patient has read this section and appreciated what surgery and the recovery entails the patient will be in a better position to discuss the possibility of bunion surgery for their symptoms.

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