Have you looked at the feet of a person, only to see that there is a bump formed on the joint at the base of their big toe? If you have, then there is a very high possibility that the person has Bunions. In today's post, I will be discussing Bunions, the big toe base joint deformity caused by a bump. https://upload.wikimedia.org/wikipedia/commons/7/76/Medical_X-Ray_imaging_RPV07_nevit.jpg

[https://commons.wikimedia.org](https://commons.wikimedia.org/wiki/File:Medical_X-Ray_imaging_RPV07_nevit.jpg) Bunions, also known as Hallux Valgus is a bone deformity affecting the foot, causing a displacement of the first metatarsophalangeal joint (MTP joint) of the big toe. Bunions are not acquired disorders, but they may be congenital, and over time in life, certain factors could lead to a person having Bunions. Looking into its epidemiology, it is one of the most common types of bone deformity, affecting about 2% of children between the ages of 9 to 10 years. It affects about 20% of the entire world's population, affecting females more than males. People who wear certain types of shoes usually have this deformity, making it common with people who wear shoes to people who walk barefoot. That doesn't mean that working barefooted is a good thing, there are numerous infections and negative health results that one could experience from working barefooted such as; Athlete's foot, Plantar warts, Tinea pedis, Paronychia, and many more. This said, there are certain risk factors that can lead to a person having Bunions, and they include; * Genetics: If parents and family members have Bunions, there is a high degree of having them. * Tight-Fitting Shoes: If a person is used to putting on tight-fitting shoes like heels, and small too small for the foot (very common in children), then there is a high chance of the person having Bunions. * People with foot anatomical abnormalities: People with foot anatomical abnormalities such as short or Dorsiflexed of the first metatarsal (a condition where the first metatarsal bone in the foot is tilted upwards towards the shin bone or tibia), Pes planus in males (also known as flat feet, which is a condition in which the arch of the feet is collapsed causing the entire sole of the foot to be in contact with the ground, leading to foot pain, and sometimes discomfort in walking or standing). * People with Abnormal foot mechanics: people who have feet that are not in the pattern of a normal foot, not causing the feet the align when moving. * Hypermobile joints: Patients who suffer from Joint hypermobility syndrome are likely to suffer Bunions. Other factors that could lead to an increased risk of Bunions include Obesity, Psoriatic Arthritis (which causes inflammation and pain in joints), Rheumatoid Arthritis (also associated with inflammation and pain in the joints), Ehlers-Danlos Syndrome (a rare disorder that affects the connective tissues of the skin, muscles, and organs), Marfan Syndrome, and muscular disorder of the feet. When there is an imbalance between the extrinsic and intrinsic muscles, affecting the ligaments of the toe (such as the medial collateral ligament of the foot) and it's joint in the foot, keeping it in place causes Bunions. With Bunions, certain clinical features can be noticed or experienced, such as Foot deformity as a result of the first toe being displaced causing valgus deformity. The bony protrusion can be painful, having a red color and numbness, and mobility can be disrupted in severe cases. Furthermore, there is another type of Bunion known as the Bunionette, also known as the tailor's Bunion which affects the fifth metatarsal joint of the foot (the pinky toe joint). While Bunion affects the medial angle of the joint, Bunionette affects the lateral angle of the joint. Similar to Bunions, people can get Bunionette by wearing fitting shoes, foot trauma, putting pressure on the lateral foot (staying in a tailor's position), people with flat feet, people with other conditions such as Rheumatoid arthritis, and also genetics can be a high-risk factor. In Diagnosing Bunions the doctor would check the joint of the big toe for bulging, and check if the toes are related to one another. The doctor would check the moving ability of the toe, while the patient is standing, walking, or sitting. The joint is checked for numbness and erythema (redness of the skin), and signs of Osteoarthritis are also checked. The doctor can order a foot x-ray in a standing position depending on the severity of the Bunion. The same would be done in the case of Bunionettes. patients can present with pain in the lateral toe of the foot. The physician examines other metatarsophalangeal joints, the ankle, and the complete foot. The doctor can examine the lateral toe region and request a Radiograph in the anteroposterior and leteral view. Treatment of Bunions would include the use of non-steroidal anti-inflammatory drugs (NSAIDs) painkillers and medications that should be taken over a short period of time, Physiotherapy (exercising the toes, and foot muscles), use of Splints to space the toes, keeping the affected toe in its right position, and operation such as the subcapital oblique osteotomy, Distal soft tissue reconstruction, chevron osteotomies, metatarsal head resection, proximal or midshaft oblique osteotomies, Ludloff variant osteotomy, and Scarf osteotomy in severe cases of Bunions and Bunionette. Management of Bunions would include wearing well-fitting shoes, not putting pressure on the toes of the feet, and using splints to separate the toes of the feet. #### Conclusion The overall complication level for both bunions and Bunionette is very low, but medical practitioners should ensure to properly examine the foot and ankles, focus first on symptomatic relief type of treatment, and should only resolve to surgical procedures in severe cases. _____ _____ https://www.ncbi.nlm.nih.gov/books/NBK513134/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907787/ https://www.nhs.uk/conditions/bunions/ https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/bunion-hallux-valgus https://www.osmosis.org/answers/bunion https://orthoinfo.aaos.org/en/diseases--conditions/bunions/ https://www.hss.edu/conditions_bunions-overview.asp https://aoj.amegroups.com/article/view/5529/html https://www.health.harvard.edu/diseases-and-conditions/what-to-do-about-bunions https://www.health.harvard.edu/bunions-and-bunionettes-overview

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