- According to Harvard Women’s Health Watch, women are 10 times more likely to have bunions than men
- Shoes aggravate it, especially high heels, because that puts more of the force at the front of the foot
- Bunions can affect a woman in many different ways, including physically, as it becomes difficult to find the right pair of shoes that don’t aggravate the bunion, and emotionally, due to being self-conscious about the appearance of her feet
You might have confused it as an old person’s problem, but it can affect many women of any age. That big bump sticking outwards from your big toe can at any point start making simple daily activities like walking and wearing those favourite pair of heels unbearable.
Sheldon Nadal D.P.M., a Toronto-based podiatrist, said a bunion is an inherited mechanical imbalance and can occur regardless of the types of shoes worn. The bump forms at the base of the big toe and is caused by a misalignment of the metatarsal, the long bone behind the big toe. Over time, the bunion can enlarge, causing pain.
According to Harvard Women’s Health Watch, women are 10 times more likely to have bunions than men. “Their shoes are less forgiving than men’s shoes,” Nadal pointed out. “Shoes aggravate it, especially high heels, because that puts more of the force at the front of the foot. Pointed shoes will cause the toes to point in together and that can increase the deviation.”
Bunions can affect a woman in many different ways, including physically, as it becomes difficult to find the right pair of shoes that don’t aggravate the bunion, and emotionally, due to being self-conscious about the appearance of her feet. Nadal recommended reducing the use of high heels and tight pointy shoes once bunions are formed.
When a bunion starts to affect a woman in her day-to-day activities, surgery becomes an appropriate option. There is the choice of either conventional or minimally invasive surgery. According to Nadal, for the last 100 years conventional surgery has been the main method used to remove bunions. The procedure takes place in a hospital and is performed by an orthopaedic surgeon.
According to Dr. Khalid Syed, an orthopaedic surgeon from Toronto Western Hospital, who performs two to three bunions surgeries every week, an ankle block is used to anesthetize the foot during conventional surgery. The surgeon makes a cut over the bunion followed by a dissection into the joint capsule (a fibrous sac of fluid surrounding the joint). The bunion bone is then cut out. Dr. Syed explained that in order to decrease the chances of the bunion coming back, the head of the metatarsal bone is cut in the shape of a chevron and is realigned by being shifted outwards. The bone is fixed with a wire that protrudes from the skin . The capsule and the skin are then closed, The entire forefoot is wrapped with a gauze dressing. After six weeks, the wire is removed by the surgeon.
After the procedure, the patient can go home the same day and is required to wear a post-op open-toe shoe for six weeks, which will help support the foot and allows the patient to weight-bear right away after the surgery. The gauze dressing must be worn for two weeks, after which time it is removed and replaced with a smaller dressing for four weeks. Some pain and discomfort may be felt for two to six weeks after the operation and there will be a scar left at the incision site.
If you’re looking to get the procedure done inside an office by a podiatrist, minimally invasive surgery is an option. According to Nadal, this procedure is performed under local anesthetic, where specialized instruments that look like a dental drill and file are used to work through small openings in the skin to remove the bunion.
“Because the openings are small, there’s much less soft tissue trauma, and there tends to be very little pain and swelling compared to regular surgery,” said Nadal, who performs minimally invasive surgery in his office regularly. He mentioned that the scar that’s left over is smaller compared to conventional surgery.
When undergoing minimally invasive surgery, first the bump is removed, followed by cutting through the first metatarsal bone to realign it. Nadal noted that he will sometimes take a small wedge from the toe bone to make the toe straighter. The patient goes home after the procedure and wears an adhesive tape dressing instead of a gauze dressing.
Minimal walking and activity is recommended for six weeks after any bunion surgery. Those who have a job that requires sitting may resume going to work after one to two weeks, however, if a lot of standing and walking is required, Nadal advised to take time off work for six weeks.
For both conventional and minimally invasive surgery, there is a risk of bacterial infection, the most common being caused by gram-positive bacteria found in the skin, which can cause bloodstream infections. Additional risks may include numbness, stiffness and the possibility of revision. Once the foot is healed, the patient may continue to perform their regular daily activities without any pain or discomfort.
If the surgery is done correctly and special care is taken, results are often permanent. Nadal recommended seeking two professional opinions and finding a doctor that is experienced in performing bunion surgeries in order to guarantee a successful result. Remember, not all orthopaedic surgeons or podiatrists perform bunion surgery. Finding a surgeon that you can trust will lead you on the path towards healthy and happy feet.
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