Bilateral Hallux Valgus In Children

Overview
Bunions One of the more common conditions treated by podiatric surgeons is the painful bunion. Patients with this condition will usually complain of pain when wearing certain shoes, especially snug fitting dress shoes, or with physical activity, such as walking or running. Bunions are most commonly treated by conservative means. This may involve shoe gear modification, padding and orthoses. When this fails to provide adequate relief, surgery is often recommended. There are several surgical procedures to correct bunions. Selection of the most appropriate procedure for each patient requires knowledge of the level of deformity, review of the x-rays and an open discussion of the goals of the surgical procedure. Almost all surgical procedures require cutting and repositioning the first metatarsal. In the case of mild to moderate bunion deformities the bone cut is most often performed at the neck of the metatarsal (near the joint).

Causes
People born with abnormal bones (congenital) in their feet. Inherited foot type. Foot injuries. Inflammatory or degenerative arthritis causing the protective cartilage that covers your big toe joint to deteriorate. Wearing high heels forces your toes into the front of your shoes, often crowding your toes. Wearing shoes that are too tight, too narrow or too pointed are more susceptible to bunions. Pain from arthritis may change the way you walk, making you more susceptible to bunions. Occupation that puts extra stress on your feet or job that requires you to wear ill-fitting shoes. The tendency to develop bunions may be present because of an inherited structural foot defect.

Symptoms
Red, thickened skin along the inside edge of the big toe. A bony bump at this site. Pain over the joint, which pressure from shoes makes worse. Big toe turned toward the other toes and may cross over the second toe.

Diagnosis
Before examining your foot, the doctor will ask you about the types of shoes you wear and how often you wear them. He or she also will ask if anyone else in your family has had bunions or if you have had any previous injury to the foot. In most cases, your doctor can diagnose a bunion just by examining your foot. During this exam, you will be asked to move your big toe up and down to see if you can move it as much as you should be able to. The doctor also will look for signs of redness and swelling and ask if the area is painful. Your doctor may want to order X-rays of the foot to check for other causes of pain, to determine whether there is significant arthritis and to see if the bones are aligned properly.

Non Surgical Treatment
Some bunions can be treated without surgery. If you have a bunion, wear shoes that are roomy enough so that they won?t put pressure on it. You can choose to have your shoes stretched out professionally or try cushioning the painful area with protective pads. Orthotics have been shown to help prevent progression of bunions. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. Applying an ice pack several times a day can also help reduce inflammation and pain. If your bunion progresses to a point where you have difficulty walking or experience pain even with accommodative shoes, surgery may be necessary. Bunions

Surgical Treatment
Bunions are painful deformities that develop when your big toe and first metatarsal slide out of alignment. Most of the time, this condition can be managed and your pain relieved using entirely conservative measures. Since this is a bone deformity, however, the problem can?t be truly corrected without a surgical procedure. Surgery for bunions realigns the displaced bones and restores the foot?s normal function.