Frequently asked questions − concerning hallux valgus / bunions

What is a bunion?

A bunion describes the state of the more or less pronounced inclination of the large toe on the outer side of the foot. As a result, this leads to a protrusion of the metatarsal head on the inner side of the foot, which, in part, occasionally leads to painful inflammations on the overlying skin (Marked red in Figure 3).

Figure 2 shows a photo of the compound bunion on the left. In the adjacent X-ray image of Fig. 1 and in the corresponding diagram of the left foot (Fig. 3), it is clear to see the sliding of the big toe from the head of the metatarsal bone in the direction of the outer side of the foot. The joint surfaces of the big toe and the metatarsal head stay together.

How does a bunion come about?

On the one hand, the disease is certainly due to a (more or less pronounced) genetic cause, which can be demonstrated by familial cumulation of forefoot deformity. On the other hand, the progression of the large toe’s malocclusion is enhanced by wearing pointed, high-heeled shoes, which is reflected in the fact that in over 90% of cases, the disease affects women, and that in societies where such shoes are not worn, bunions are very rare.

How can bunions be prevented?

In general, the risk of the formation of a bunion can be reduced by avoiding the wearing of pointed, high-heeled shoes. Above all, people with a history of bunions in their family should refrain from wearing such footwear.

Can a bunion be treated conservatively?

Practically, this defective position can only be treated by means of an operational procedure, even if the so-called bunion rails or post-support rails always provide a different impression. Such rails can sometimes lead to temporary relief from discomfort on the balls of the foot. However, their use does not lead to a permanent correction of the altered anatomy of the bone (the metatarsophalangeal joint capsule and tendons) which is indispensable for definitive healing.

More information on bunions can be found in the section foot surgery.

It is self-evident that many questions remain unanswered.

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