Foot surgery hammer toes bunions

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

A bunion is caused by osteoarthritis affecting the first tarsal meta-tarsal joint at the base of the big toe.

The end result is the joint deforms and causes the toe to bend toward the other toes. On the inside (medial) part of the joint, a small sac of fluid (bursa) becomes inflamed and this contributes to the swelling and pain associated with a bunion.

The MTP joint carries much of the body weight while walking.

As a result, bunions can cause pain. The MTP joint becomes stiff and sore, making the wearing of shoes difficult.

Treatment options vary with the type and severity of each bunion. Identifying the deformity early is important to avoid surgery.

Obviously, when possible, non-surgical solutions that a patient can live with are preferable to surgery.

A hammer toe is another condition that causes pain. It occurs when the toe bends at the proximal interphalangeal joint (the row of joints that are distal to the MTPs). When the toe is fixed in this position the top of the top rubs against the top of the shoe and the tip of the toe rubs the bottom of the shoe and develops blisters and calluses.

The primary goal of most early treatment options is to relieve pressure on the bunion and hammer toe and halt the progression of the joint deformity.

Several surgical procedures are available for bunions. The purpose of surgery is to remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain.

A bunionectomy, in which only the bony swelling is removed, may be used for less severe deformity. Severe bunions require a more involved procedure, which includes cutting the bone and realigning the joint. Similar procedures for straightening hammer toes are also performed.

Recuperation takes time, and swelling and some discomfort are common for several weeks following surgery. Pain can usually be managed with medications including anti inflammatory medicines and analgesics.

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