A PROBLEM IN YOUR BIG TOE

Your big toe is the hardest working toe. Every time your foot pushes off the ground, this toe supports most of your body's weight. Because the big toe is so critical to movement, any problem with it can make walking or even standing painful. A bunion (excess or misaligned bone in the joint) is one of the most common big-toe problems. In addition to causing pain, a bunion changes the shape of your foot, making it harder to find shoes that fit. But you don't have to hobble for the rest of your life. Bunions can be treated. With your doctor's help, your feet can feel and look better.

WHAT CAUSES BUNIONS

Although they may develop on the fifth (little) toe, bunions usually occur at the base of the big toe. Bunions are often caused by incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. In some cases, joint damage caused by arhritis or an injury produces a bunion. And some people are simply born ith extra bone near a toe joint. If you're at risk for developing a bunion, wearing high-heeled or poorly fitting shoes make the problem worse.

Positional Bunions

As new bone grows, the joint enlarges. This stretches the joint's outer covering. Force created by the stretching pushes the big toe toward the smaller ones. Eventually, the inside tendons tighten, pulling the big toe farther out of alignment.

Structural Bunions

When the angle between the bones of the first and second toes is greater than normal, the big toe slants toward the smaller ones. In sever cases, this may also cause the second and third toes to buckle.

HOW ARE BUNIONS TREATED?

If a bunion is not severe, your doctor may recommend that you wear a different style of shoes. Or you may be prescribed custom-made shoe inserts (orthoses) to control incorrect foot mechanics. For severe bunions, outpatient surgery may be recommended. Within hours aftre your surgery, you'll be on your way home and ready for recovery.

Shifting Soft Tissue

To realign the affected joint, any tight tendons on the inside of the toe are released. New bone that makes up the bunion is shaved away.

Shifting Bone

The most common bunion surgery reduces the angle between the first and second toes. Bones in the big toe are realigned and the bunion is shaved away. Ligaments and tendons on the outside of the toe may be tightened to hold the joint properly.

Removing Bone

If a structural bunion is severe, a peice of bone is removed from the first metatarsal (the long bone behind your big-toe joint). Once repositioned, this bone may be held in place with a pin or screw. Any new bone that makes up a bunion is shaved away.