Bunions and Hammertoes
The foot and ankle work together to provide balance, stability, movement and propulsion. Toe deformities cause pain, and difficulty fitting into shoes. The toes and toe joints are integral to movement. They bear the weight of the body, and provide balance and support when you walk and run.
Bunions are a deformity of bone and tissue at the base of the big toe joint that creates pain and inflammation. Hammertoes are another deformity commonly due to a tendon imbalance causing the second toe joint to elevate, resulting in dysfunction. Bunions and hammertoes can develop under the same conditions, and often occur together, when the big toe pushes on the second toe causing misalignment.
Bunions occur when bones in the foot are not in alignment. The first metatarsal bone in the foot shifts to the inside (arch) of the foot, and the bone of the big toe moves toward the second toe, in the opposite direction. The MTP joint enlarges and protrudes out the side of the foot. The deformed joint can cause the foot to rub against footwear causing calluses and corns, inflammation and pain.
Hammertoes involve the middle joint of the second toe, and sometimes the third, fourth and fifth toes. Hammertoes become painful when they rub in the shoe box.
Bunions and hammertoes develop over time. At first they may be small, but progressively get worse- especially when the patient continues to wear tight shoes. Bunions are painful with every step, the bigger they get the worse they hurt and interfere with walking.
Risks and Causes
- Trauma, stubbing, jamming or breaking of a toe may increase the risk of a hammertoe.
- Abnormal muscle balance in the toes that causes instability and forces the toe to contract.
- A second toe that is longer than the big toe puts you at higher risk for foot deformities, related to heredity.
- When the toes are squeezed together by pointy- toed high heels, the risk of developing a bunion increases.
Nonsurgical treatment: Wider shoes, orthotics or padding, activity modification and NSAIDS.
Wearing wider shoes may ease pain and discomfort, but is not a cure. When conservative treatment fails to treat bunion or hammer toe pain, surgery may be recommended.
Bunion and Hammertoe Surgery
Surgery is intended to correct the deformity by removing the bony tissue, releasing tight tendons and aligning the toe joint. Surgical goals include pain relief and realignment of the bones to enable the patient to walking on the soles of his or her feet with the toes touching the ground. This is important because the soles of the feet carry the weight of the entire body.
Bunion surgery is called an osteotomy. Hammertoe surgery may address soft tissue disorders, and/or may involve joint resection and fusion. Surgery is an outpatient procedure. There are a variety of surgical procedures for bunion and hammertoe surgery, depending on the individual patient’s needs.
What to expect during an office consultation visit
During your consultation with Dr. Arash Aminian at South County Orthopedic Specialists (SCOS) in Orange County, CA, he will conduct a physical examination of your gait, shoe wear, range of motion, mobility, your neurovascular system. Patients will also receive x-rays. You and your doctor at SCOS will talk about the types of surgeries and recommend the best option for you.
Indication for surgery
The primary indication for surgery for bunions and hammertoes is foot pain that interferes with daily activities, after conservative measures fail. Surgery is inappropriate where it is sought for cosmetic reasons alone, because there is a risk that the surgically treated toe may develop pain where none existed before surgery.
An important consideration in making your decision to have bunion surgery is that a long recovery is required. Your outcome will be determined by how well you follow your doctor’s instructions. During recovery you will be at home for one to two weeks. It will take several months to heal and you will need to wear special protective footwear. After healing the choice of shoes available to you will be improved. Bunions can reoccur when the patient resumes wearing tight fitting shoes.
Dr. Arash Aminian, MD is an expert is foot and ankle surgery. He is Fellowship Trained and skilled in foot and ankle conditions. He provides personalized care to all his patients with a calm, compassionate demeanor. In Orange County, California, SOCS orthopedic surgeons strive to provide patients with excellence in care and commitment to their patients in the Irvine and Laguna Woods locations.
Foot & Ankle Specialists
Arash Aminian, MD
Dr. Arash Aminian specializes in the care and treatment of foot and ankle disorders at South County Orthopaedic Specialists. Read Dr. Aminian’s biography.