Treatment Of Bunions and Hammertoe Deformities


What exactly is a bunion and a hammertoe?

A bunion, or better known medically speaking as Hallux Abducto Valgus Deformity (HAV), is a bony deformity of the foot that tends to worsen over time. A bunion is a deviation of the big toe and the associated metatarsal bone. It occurs when the big toe drifts over to the lesser toes and causes what appears to be “a bump” on the side of the feet. A hammertoe is when a toe starts to curl and may appear to be dislocated at the knuckles of the toe. Typically, as a bunion worsens and moves over it will push against a hammertoe thus making it worse.

Who gets a bunion and hammertoes? 

It is difficult to predict who will get a bunion. It can be seen in a wide array of people including young teenagers, middle aged individuals and seniors. The causes of a bunion are debated within the medical community but it seems to be caused by many different factors including genetics, flatfeet and tight shoe gear. When a hammertoe is associated with a bunion, the bunion is usually the cause of the hammertoe. When there are hammertoes of all the toes, and no bunion deformity, it is usually due to significantly high arched feet.

How can one treat bunions and hammertoes?

There foot deformities are usually first treated conservatively. Bunion splints, toe spacers, hammertoe crests, ice, wider shoes, appropriate orthotics and medication can help treat these painful deformities. Conservative treatment is successful most of the time to prevent surgical intervention. These treatment modalities are usually all that is necessary, but in some circumstances surgical intervention is warranted. 

What does this type of surgery entail?

There is a wide array of different types of surgeries to correct the deformities. Your surgeon will determine which type of surgery to perform based on your symptoms, age, x-rays of your feet, level of activity etc. Once the surgeon takes all these factors into account she will let you know if you will have hardware placed in the foot to help correct the deformity.  Surgery does require anesthesia and is usually performed in an operating room under the surveillance of an anesthesiologist. 

Depending on what type of surgery you have the recovery can range from 2-8 weeks with the use of crutches or walker. The type of surgery performed will dictate the type of weight bearing that is allowed. 2 months post operatively one may begin to return to regular shoe gear. After surgery, it is highly recommended to wear custom orthotics long term to prevent re-occurrence of the deformity.