Please enable JavaScript.
Coggle requires JavaScript to display documents.
Bunions - Coggle Diagram
Bunions
Causes
Pes planus (loss of the medial longitudinal arch or 'flat foot') — this may co-exist due to increased pronation of the great toe.
-
-
-
-
-
-
-
-
-
Management
Consider referring to MSK service for: advice on balance, proprioception, core stability, calf muscle stretches, treatment of tibialis posterior tendon dysfunction, possible corticosteroid injection(if unfit for surgery)
If symptoms persist consider referral to orthopaedic ankle and foot specialist or podiatric surgery.
Offer referral to podiatry for footwear assessment and/or consideration of a night splint or orthosis
Advise on self-care measures for symptom relief: wear low-heeled, wide-fitting shoes with soft sole and toe box, avoid high heeled or tight fitting shoes, consider use of insoles/toe spacer/bunion pads, consider use of ice, advise on use of simple analgesia.
Arrange urgent referral in impending or non-healing foot ulcer, or suspected peripheral limb ischaemia.
-
-
-
Diagnosis
-
Progressive pain at the medial aspect of the first metatarsophalangeal (MTP) joint and/or medial aspect of the forefoot
-
-
Assessment:
Examination:
-
-
Assess skin quality and examine for associated complications such as calluses, corns, bursitis, skin breakdown, and lesser toe deformities.
Palpate the first MTP joint, lesser toes, and forefoot for areas of pain and tenderness.
-
Assess the range of movement of the first MTP joint, other foot joints, and ankle
-
-
-
Ask about:
-
Difficulty fitting into footwear, normal footwear worn, any changes in footwear.
-
-
-
-
Surgical management
May be required depending on the severity and location of deformity and the extent of degenerative changes of the first metatarsophalangeal (MTP) joint.
Definition: A bunion (hallux valgus) describes a toe deformity when the great toe (hallux) laterally deviates away from the midline towards the lesser toes. This causes medial prominence of the first metatarsal head, and the overlying bursa and soft tissues may also become inflamed.