Commonly known as a bunion, this is a complex deformity affecting the big toe,
the first metatarsal and the metatarsophalangeal joint. In this deformity, the big
toe is abducted with certain rotation (valgus) in the frontal plane, while the first
metatarsal is adducted rotating in varus, creating an articular incongruity, resulting
in the dislocation of the first metatarsophalangeal joint and affecting other
structures and ligaments, the joint capsule and both the intrinsic and extrinsic
musculature.
It can appear as a result of certain factors, such as abnormal development due
to a pathomechanical deficit, wearing inappropriate footwear, pregnancy and
menopause, and arthrosis, mainly affecting women. Today, it is considered a
multicausal disorder in which genetics, footwear, hormonal and other factors
may be present.
Symptoms
Bone deformity with axial deviation of the first metatarsophalangeal joint. Pain
due to pressure and/or friction caused by footwear.
Inflammation of soft tissue due to the bone deformity, accompanied by deformities
such as hammertoe and claw toe in the adjacent toes.
Orthotic Treatment
Preventative or conservative treatment by means of corrective splints for day
and/or nighttime use can prevent the progression of the deformity when its onset
and clinical manifestations, such as pain or signs of arthrosis, become evident.
In the event of requiring surgery, splints, together with specific plantar orthoses,
are very useful to ensure that the surgical correction is maintained. Plantar
orthoses can improve the load distribution of the big toe and reduce pain in static
and dynamic activities. Silicone or gel protectors used for exostosis can relieve
pain when wearing shoes. In addition, post-surgery shoes can help patients to
walk and stand while wearing a postoperative dressing during recovery.