Bunions & Deformities of the Toes

Protrusions or enlargements of the big toe joint on the inner side of the foot are the most common type. The big toe is directed sideways toward the second and causes the foot to be wider across the metatarsal. The first metatarsal protrudes out of the middle of the foot, and the joints, muscles, and tendons become displaced and strained. We will see the following types of bunion deformities:

• Hallux Valgus
• Articulation of the great toe joint becomes distorted, causing unequal weight bearing of the foot and gait abnormalities.

• Tailors Bunion
• Similar to hallux valgus except occurring on the fifth metatarsal.

• Hallux Rigidus
• The protrusion of the first metatarsal joint occurs at the top of the foot. Often the joint has chips and spurs and cannot move.

• Hammertoes
• Bending of the toe at the first joint with pressure at the top and tip of the toe. The condition usually affects the second through fifth toes. Treatment options vary according to each situation; identifying the deformity may help avoid surgery. Untreated hammertoes may become rigid and might need surgery if non-surgical treatment does not work. Examination and X-ray of the affected area will guide our treatment. There are two types:
• Flexible hammertoes
•  Moveable at the joints, these toes change with pressure and position.
• Rigid Hammertoes
•  As the deformity develops, the tendons become tight, and the joint is misaligned and immobile. Bone Spurs may develop.
• Mallet Toe
•  Bending of the toe at the second joint often associated with pain at the tip of the nail. Treatment options are similar to hammertoe.
• Mal-aligned Toe
•  This abnormal position, from birth or acquired over time, may arise because of joint instability, muscle imbalance, and abnormality in the tendon, ligament, or skin. Corn, callus, or pressure may result.