Bilateral Hallux Valgus Interphalangeus

Overview
The term "hallux valgus" or "hallux abducto-valgus" are the most commonly used medical terms associated with a bunion anomaly, where "hallux" refers to the great toe, "valgus" refers to the abnormal angulation of the great toe commonly associated with bunion anomalies, and "abductus/-o" refers to the abnormal drifting or inward leaning of the great toe towards the second toe, which is also commonly associated with bunions. It is important to state that "hallux abducto" refers to the motion the great toe moves away from the body's midline. Deformities of the lower extremity are usually named in accordance to the body's midline, or the line bisecting the body longitudinally into two halves. In more severe cases, the hallux continuing in the abductus fashion eventually either overlaps or underlaps subsequent lesser (small) toes especially the second (adjacent toe).

Causes
A bunion is more common in women than men due to women wearing tighter fitting shoes. This condition can cause a variety of different soft tissue and bony complaints which may result in severe pain.

Symptoms
Pain or soreness. Inflamattion and redness. A burning sensation. Numbness on the side of the great toe. Other conditions which may occur secondary to bunions include calluses on the big toe, sore between the toes, ingrown toenails, and stiffness of the joint where the great toe attaches to the foot.

Diagnosis
Clinical findings are usually specific. Acute circumferential intense pain, warmth, swelling, and redness suggest gouty arthritis (see Gout) or infectious arthritis (see Acute Infectious Arthritis), sometimes mandating examination of synovial fluid. If multiple joints are affected, gout or another systemic rheumatic disease should be considered. If clinical diagnosis of osteoarthritic synovitis is equivocal, x-rays are taken. Suggestive findings include joint space narrowing and bony spurs extending from the metatarsal head or sometimes from the base of the proximal phalanx. Periarticular erosions (Martel sign) seen on imaging studies suggest gout.

Non Surgical Treatment
If overpronation is diagnosed early enough, the mechanics of the feet can be adjusted using a prescription orthotic. If orthotics are worn consistently, many major foot deformities can be avoided such as bunions. Early detection is of paramount importance. When a bunion progresses and cannot be controlled by an orthotic, surgical correction may be a consideration. Many advances in bunion correction allow for surgical intervention to make healing and return to normal activities much easier than use of traditional bunion surgery.

Surgical Treatment
As mentioned above, with mild cases, the bone is cut close to the big toe joint and shifted over into a correct position. The cut bone is held in placed with one or two surgical screws. With this procedure, just the top of the bone is moved over and the bottom of the bone remains in the same place. This technique is called the Austin bunionectomy and refers to type of bone cut that will be made by the Surgeon. There is, however, a limit on how far one can move the bone over with this technique. Its is generally thought that the cut bone should only be moved over a distance equal to half the width of the bone. In somes the bone may be moved over further.

Prevention
Shop for shoes that possess a removable liner, or insole, and stand on the liner after you have removed it from your shoe. This is an effective method to see if your shoe is wide enough in the forefoot to accommodate your bunion. If your bunion and forefoot are wider than the insole, your shoe will squeeze and constrict your bunion and create the symptoms that define this health problem. The insole should also be wide enough to fully accommodate your big toe when it points outward, away from your other toes.