Results of Surgery for BunionsSevere bunions often require surgery to correct this painful deformity. The medical term for bunion is hallux valgus deformity. In this study, the results of reconstruction surgery for hallux valgus are reported.
The surgical procedure used was a proximal osteotomy of the first metatarsal. An osteotomy is the removal of a wedge- or pie-shaped piece of bone from one side of the bone. The rest of the bone is then shifted in the direction of the missing bone. This helps realign the toe in a more neutral position.
A metatarsal is the main bone in the forefoot at the base of each toe. The first metatarsal is at the base of the big toe. The first metatarsal and toe is also called the first ray.
The authors showed X-rays of severe hallux valgus deformities before and after surgery. Surgery was done for patients who had severe pain and difficulty wearing shoes. Details of the X-ray exam and surgical procedure were provided.
Results were measured by pain levels, ankle motion, and movement of the first ray. Foot imprints made on a mat and angles measured on X-ray were also used to track progress. Mat imprints were used to assess how flat the feet were.
The authors report there was no evidence that limited ankle motion was linked to the formation of bunions. About 15 per cent of the patients had a very low arch. This did not cause increased rotation of the first ray or angular changes contributing to bunions.
Recurrence of the hallux valgus deformity can occur after surgery. Hypermobility (increased motion) at the first ray has been blamed for this problem. The results of this study did not support the hypermobility theory of bunion recurrence.
Overall, this study showed that osteotomy with soft tissue realignment was a reliable way to correct a hallux valgus deformity. Patients were satisfied with the functional results. Recurrence was rare. A few patients expressed some concern about the final cosmetic appearance.
Michael J. Coughlin, MD, and Carroll P. Jones, MD. Hallux Valgus and First Ray Mobility. In The Journal of Bone and Joint Surgery. September 2007. Vol. 89-A. No. 9. Pp. 1887-1898.
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