Bunions and haglunds deformity
Bunions
Bunions develop gradually and ultimately may require surgery to correct them.
A bunion is an enlargement of the joint at the base of the big toe caused by a misalignment of the joint. The big toe tends to move over towards the other toes and the first metatarsal bone tends to deviate away from the other metatarsals. It is often characterised by arthritic changes and usually gets progressively worse and more painful. They can often be aggravated by tight footwear or creasing in the wrong place and then the soft tissues can become affected causing superficial sores or deeper blisters called bursas.
These deformities as with others can all predispose a person to pressure points and wounds forming which can be especially troublesome and dangerous in someone with diabetes.
Bunions usually form as a result of one of the following or a combination of them:
- Inherited foot structure issues
- Biomechanical abnormalities
- Neuromuscular disorders
- Inflammatory joint disease (arthritis)
- Trauma
- Congenital deformities
- Occlusive footwear
Generally our first line of treatment is to prevent the problem becoming worse by giving advice ,padding to protect and orthotics to offload and change the function of the foot. Bunions deteriorate gradually and eventually may require surgery. However, surgery itself has risks and often after the operation the causative factors such as poor fitting shoes or poor foot function are not addressed.
Haglund’s deformity
They are a bony growth called an exostosis and form as a result of repetitive trauma from the heel counter of the shoe rubbing and putting pressure on this area. The bone responds by laying down more bone which then can become irritated by there being even more pressure from shoes –it’s a bit of a vicious cycle of events. Often caused by abnormal amounts of Pronation the process can usually be halted or at least reduced by having orthotics made to address the abnormal gait and foot function. See gait analysis.