Bunion Pain Hallux Abducto Valgus Surgery

Dr. Glass DPM Podiatry Resource Network glass.dpm@gmail.com www.drglass.org
A "Hallux Valgus" or "Hallux Abducto-Valgus" deformity, is commonly referred to as a "Bunion." This describes a pathological condition involving the position of the "hallux" in relation to the first metatarsal.

A bunion deformity can clinically present with a variety of characteristics. The foot itself may present with a wide splaying of the forefoot and a painful bump on the medial aspect of the first metatarsal phalangeal joint. In addition, the hallux may be abducted from the midline of the body, with a valgus rotation in the frontal plane.

A radiographic analysis of a bunion deformity in the Anterior/Posterior or Dorsal/Plantar view will reveal a variety of pathological components. Most notably so, is the exaggerated inter-metatarsal angle between the first and second metatarsal. This may be accompanied by a displacement of the first metatarsal from its position over the sesamoids, such that the metatarsal demonstrates a medial alignment away from the sesamoids which lie to the lateral side.

In some cases, the proximal articular set angle at the head of the first metatarsal may be off-set. This "PASA" is one of the factors which determines the position of the proximal phalanx on the metatarsal during movement as well as at rest.

Although conservative care may involve shoe modifications, padding, strapping, and custom orthosis; surgical reconstruction may be required to alleviate painful and immobilizing bunion conditions.

Soft tissue components of the bunion deformity are primarily addressed by means of a capsular modification, as well as a tenotomy of the adductor tendon at its insertion on the base of the proximal phalanx. The fibular sesamoid may be repositioned by a release of the surrounding ligaments.

Surgical management of the bone or osseous components of a bunion deformity will commonly include an osteotomy and correction to re-establish a more functional position of the first metatarsal within the forefoot. This capital fragment of bone is held in place with hardware fixation in order to secure a proper alignment during the healing phase, thus allowing the hallux to return to a more functionally useful position in the sagittal plane.

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• abduct
• valgus
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• kalish
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• bump
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• capsule
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[U2LedZep]

I'm scared to death to get this bunion surgery... Most likely going to get it next year. I was born with uneven legs (didn't even know that till recently!) that caused the bunion. But I'm really nervous to get it fixed and everytime I look up videos or try to get more information on the surgery I get so anxious.

Ahh..guess I'll just have to wait and see :/

[DrGlassDPM]

@U2LedZep Hang in there! Surgery videos tend to make most people a little uneasy, when it comes to themselves.

[hoghvn417]

I just had this surgery done 11/17/10. Full description on my insurance statement is called: Correction, Hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, Chevron, or concentric type procedures)

Glad I did it! 30+years of pain! It was an out patient procedure very similar to what this video shows. First week is the hardest during recovery, pain pills worked. Weaned myself off pills in 10 days, started getting stomach cramps. 2 weeks left in boot

[DrGlassDPM]

@hoghvn417 That's honestly a pretty typical course. Pain medications have some side effects, but once your through the first week, its often much better thereafter.

I'm glad your doing well!

[lestat1020101]

This video is so helpful to those people that life has been turned upside down after the surgeries. I had three. I then developed CRPS I am in stage three now and there is no cure for this and I just wanted to know if my first doctor did this to me. This takes so much off my mind.

[DrGlassDPM]

@lestat1020101 Chronic pain can develop for a number of reasons, whether from surgery or not. I hope this video explains a little about the surgery itself, but it's hard to say anyone is "at fault" per se

[iv445]

Very informative and educational!

[swissdude101]

I have had pain in my sesemoids for a long time, i recently looked it up, and it looks like i have sesamoiditis, i have always had to wear wider shoes, but never thought anything of it, any suggestions?

[kristintbeaulieu]

I'm getting my sesamoid removed soon. They break all the time and won't heal.

[DrGlassDPM]

@yolenka707 I appreciate it

[DrGlassDPM]

@danixiboeee Thanks

[danixiboeee]

Really cool man ...