Crooked Big Toe?

Over half the women in the United States have a crooked big toe commonly known as a bunion and medically known as hallux valgus, according to the American Academy of Orthopaedic Surgeons.

A bunion is a misalignment of the big toe, which causes it to turn towards the other toes and creates a bump on the inside of the foot. In some cases, the bunion causes pain and, if left untreated, bunions may lead to arthritis.

It is easy to see a bunion on your big toe. However, it is important to have a clinical examination and a weight bearing x-ray to determine the form of treatment that may help improve the condition. A weight bearing x-ray is one that requires the patient to put their weight down on the entire foot. That’s the only way your doctor can determine the true extent of the deformity.

“Most people believe that bunions are caused by wearing shoes with narrow toes that are too tight. This is not necessarily the case,” says Christopher Hodgkins, M.D. an orthopedic surgeon who specializes in foot and ankle surgery with Doctors Hospital Center for Orthopedics & Sports Medicine.

“The real cause of a bunion is a good question,” Dr. Hodgkins says, “mainly it is a genetic predisposition, much more common in females than males, and possibly accelerated by wearing narrow shoes and fancy high heels. If you leave the bunion without correcting it for a long period of time, it might lead to arthritis.”

“Generally found in mid- to older-age females, there is no quick easy fix for the bunion,”, Dr. Hodgkins says., “Unfortunately, there is no way to permanently correct the deformity non-surgically. A bunion requires surgery and six months to one year of recovery time which most people do not realize.”

Before considering surgery, Dr. Hodgkins speaks candidly with his patients about the surgery and the different types of surgical techniques available to fix the deformity.  Surgery should be considered if a patient’s quality of life is altered by pain, limitation of function or the appearance of the bunion. Dr Hodgkins will not offer surgery unless he thinks it is absolutely necessary. He says he will always offer non surgical treatment methods initially.

There are treatments available that may be used to treat the bunions non-surgically, which aim to control the symptoms of the deformity but may not be permanent. Based on your evaluation, your doctor can determine if orthopedic shoes, custom-made inserts, medications or something else might help the condition.

A few non-surgical treatments are sometimes practiced but do not correct the condition, nor do they stop the progression of the deformity.  Some of these include:

• Splints which try to pull the toe back into its normal position.
• Padding which is placed inside the shoes, to distribute the pressure away from the bony prominence and alleviate the pain.
• Toe spacers which are placed between the big toe and smaller toes to prevent the big toe from hitting the other toes.

“Regardless of what form of treatment you choose, make sure you visit a fellowship trained orthopedic surgeon who specializes in foot and ankle surgery to discuss your options,” Dr. Hodgkins says…Bunions may come back and surgical complications can occur. It is important to see a well qualified surgeon and always get a second opinion.”
For more information about bunion and foot and ankle surgery at Doctors Hospital Center for Orthopedics & Sports Medicine, call 786.308.2888.

About Christopher Hodgkins, M.D.
Christopher Hodgkins, M.D., is an orthopedic surgeon specializing in conditions of the foot and ankle. His areas of expertise include sports injuries, tendon disorders, fractures, traumas, post-traumatic reconstructions, arthroplasty and fusion for arthritic conditions and forefoot reconstructions including bunion and hammer toe surgery. Dr. Hodgkins received his medical degree with honors from the University of Manchester in England. He completed his orthopaedic surgery residency at the University of Miami/Jackson Memorial Hospital. He has completed 2 years of foot and ankle fellowship, at The Hospital for Special Surgery in New York in 2005 and The Florida Orthopaedic Institute in Tampa in 2011. Dr Hodgkins has published extensively in international medical journals and textbooks on sports injuries and surgical techniques. He has presented at numerous national orthopaedic meetings and has won awards for such.