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Bunion Deformity

A bunion is a foot deformity caused by abnormal shifting of the first metatarsal bone (the bone behind the toe bones) away from the lesser metatarsal bones. It generally appears as a bump at the base of the great toe that gets bigger over time. Sometimes the skin over this bump may become red and irritated and a callous may form over the bump as well. The bump itself is actually the end of the bone called the “head”. As the metatarsal bone continues to shift, the head will become more prominent. This occurs for a multitude of reasons including:
Narrow/pointed toe shoes; abnormal foot mechanics; excessive mobility of the joints in the foot; and there is also a genetic predisposition to develop bunions.

Bunions are a structural and progressive deformity which can worsen over time and can become very painful, limiting the ability to walk comfortably and to wear shoes comfortably. There are ways in which a bunion deformity can be managed and made more comfortable in shoes. These include:

  • Padding
  • Wider shoes
  • Bunion splints
  • Wearing open-toed shoes/sandals

Additionally, custom orthotics may be helpful to control movements of the foot that may contribute to worsening of the deformity over time. However, they will not correct the deformity that is already present.

If conservative care fails to alleviate the pain, then surgery to realign the metatarsal bone back behind the great toe may be pursued. This is an outpatient surgical procedure which takes an hour or less to complete. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on bunion surgery, please follow this link:

“Austin Bunionectomy with Screw Fixation” Thalia Oster

(This video includes live operative footage and may be disturbing to some audiences.)

In cases of very severe bunion deformity, or when there is excessive motion in the joint at the base of the first metatarsal bone, a more proiximal (closer to the leg) procedure may be necessary. This may include fusing the joint between the first metatarsal bone and the bone behind it, called a cuneiform bone. This is also an outpatient procedure which takes between 1 ½ and 2 hours. Following this procedure, patients must remain non-weight bearing with crutches for approximately 6-8 weeks. For more information about this procedure, consult your podiatrist.

If you would like to watch a video on this type of surgery, please follow this link:

“Lapidus Arthrodesis (ENG)” Normed Germany

(This video includes live operative footage and may be disturbing to some audiences.)