About Bunions
Learn About Symptoms
A bunion is a bony protrusion that occurs at the joint just behind the big toe.
What Causes a Bunion?
An estimated millions of Americans live with deformities of the big toe and fortunately there are options for correction.¹ A bunion, or hallux valgus in medical terms, is the resemblance of a bony bump on the inside of the foot at the big toe joint. Bunions develop when the big toe drifts toward the outside of the foot, while the metatarsal (the bone behind the big toe) moves toward the inside of the foot. This drifting may be caused by an unstable joint in the midfoot which allows the bones to shift out of alignment.²
Common causes of bunion may include:
Heredity
Some people inherit feet that are more likely to develop bunions due to their shape and structure.
Shoe Type & Fit
Shoe fit and type, like high heels, can increase the likelihood of a bunion.
Medical Conditions
Conditions like rheumatoid arthritis and certain neuromuscular conditions can lead to bunion formation.
Learn About Symptoms
A bunion is a bony protrusion that occurs at the joint just behind the big toe
A bunion or the medical term “hallux valgus” is a complex deformity of the great toe of the forefoot. This deformity is, at times, red and painful and can disrupt daily activities. If correctly identified and treated, the symptoms will vastly improve(1).
Hallux valgus is typically diagnosed through a physical exam and imaging. Imaging can inform the doctor if there is damage to the great toe joint. Non-surgical approaches to bunions include wider shoes, orthotics, and night splinting. If conservative treatment proves ineffective, surgical management could be the next recommended course of action(2).
What is my Condition?
Your bunion will be assessed by your doctor, but can be categorized into three general buckets – Mild, Moderate and Severe, and can be confirmed via x-ray. As the deformity progresses, you may find difficulty fitting into traditional shoe wear and may notice pain and discomfort with basic physical activity. Surgery may be required as other portions of the foot may be impacted with deformity progression.
Mild Bunion
Resemblance of a bump starts to form on the inside of your toe which could start to rub against the inside of a shoe, but may not cause any discomfort.
Moderate Bunion
Bump is a bit larger with a potential of redness. Discomfort while performing normal day to day activities may be present.
Severe Bunion
Bump is very prominent with the big toe facing toward other toes. Constant discomfort and pain may be present.
See if the MIS procedure is right for you
Take the survey below to see if you qualify for a new minimally invasive bunion surgery.
How are Bunions Diagnosed?
During a clinical exam, the doctor will look at the appearance of your foot and toe positioning manually assessing the range of motion of the toe to determine what the best course of action is depending on the severity of the deformity. The doctor will palpate further up the toe towards the ankle and assess for instability. X-rays of the toe will be gathered to aid in determining the severity of the deformity.
What if I do Nothing?
Early stage bunion deformities can gradually worsen over time with the associated symptoms:
Increased and Worsening Discomfort/Pain – Untreated bunions can lead to significant swelling, pain, and cosmetic changes.5
Osteoarthritis or Bursitis – If the joint(s) impacted by the deformity have sustained extensive damage, the cartilage in the joint may begin to deteriorate, causing the bones which make up the toe to rub together.
Crossover Toe – With progression of the deformity, the second toe may deviate over the first toe causing pain, callusing, and even ulceration of the second toe.3,4
What are my Options?
As a patient you need to know that depending on the type and severity of your bunion there are many ways to treat it.
It is important to make sure that you consider options instead of looking for a one-sized-fits-all approach.
See below for a minimally invasive surgical treatment options offered by Paragon 28 or view our Treatment Options page.
Phantom® MIS
The new Phantom® MIS procedure consists of three small surgical incisions made in the foot, and the intramedullary nail placed at the point of the bunion. Recovery time may be quicker than traditional surgery because of its minimally invasive nature.
Precision® MIS
The Precision® MIS Bunion System, known as a Distal Metatarsal Osteotomy (DMO), may be considered for mild to moderate bunion deformity. This procedure IS JOINT SPARING, and may allow you to get back to your normal activities faster because of its minimally invasive surgical approach.
Recovery
Typically, MIS surgery allows for faster recovery and weightbearing.
Depending on your surgeons’ treatment, this may vary.
Frequently Asked Questions
Are my shoes causing my bunion?
Poor fitting shoes may contribute to the deformity as it can push the toe into an unnatural position. Over time, the soft tissue in your foot may become accustomed to the new positioning and cause a worsening deformity.
When do I need to have surgery – how long should I delay?
Bunion deformities are progressive conditions which may not improve without intervention. Addressing these deformities early before arthritic changes begin to take place in the toe may allow for interventions which do not require fusions or other more invasive procedures.
How long until I can get back to normal activities?
This is dependent on your surgeon’s recommendation and procedure utilized. Please see product pages for their timelines.
What procedure it best for me?
No procedure has a one-sized-fits-all approach. Each person needs to be treated as an individual and the procedure chosen specifically to the severity of their bunion.
I have been reading a lot about 3D bunion correction. What does this mean?
The term 3D is used to describe bunion procedures that not only shift bone but rotates it as well. These three planes are considered “3D” correction. Our bunion procedures allow 3D correction.
Important Risk Info
Only a surgeon can tell if the Phantom® Intramedullary Nail, Phantom® MIS Procedure and/or Precision® MIS Bunion System is right for you. There are potential risks, and recovery takes time. Potential risks include but are not limited to infection, discomfort, or swelling due to balancing and introduction of the implant, loosening of the implant, and loss of correction. Refer to full list of warnings precautions, and contraindications within the Phantom® Small Bone Intramedullary Nail and Precision® MIS Bunion System Instructions for Use at https://paragon28.com/ifus/
Surgeon Finder Disclaimer
The surgeon information listed in the Surgeon Finder is provided for informational purposes only and does not represent an endorsement or warranty of any particular surgeon. The database does not include an exhaustive list of all surgeons within a particular geographic area or all surgeons who use/have used a Paragon 28® product. Only those who have expressly subscribed to be listed on the site and are confirmed to be either Paragon 28® trained and/or experienced are included. These are the only criteria for inclusion. Paragon 28® does not pay a fee or any other type of remuneration for participation. Choice of surgeon should be solely based upon a patient’s own investigation of a particular surgeon’s training, education, experience and reputation.
For the contraindications, potential complications and adverse reactions, warnings and precautions associated with this device, please refer to the device specific instructions for use here.
Sources
Lee M, Walsh J, Smith MM, Ling J, Wines A, Lam P. Hallux valgus correction comparing percutaneous chevron/Akin (PECA) and open scarf/Akin osteotomies. Foot Ankle Int. 2017;38(8):838-846. doi:10.1177/1071100717704941
Maffulli N, Longo UG, Oliva F, Denaro V, Coppola C. Bosch osteotomy and scarf osteotomy for hallux valgus correction. Orthop Clin North Am. 2009;40(4):515-524. doi:10.1016/j.ocl.2009.06.003
Blitz NM. Current concepts in minimally invasive bunion surgery. Podiatry Today. 2019;32(2):28-34.
Lam P, Lee M, Xing J, Di Nallo M. Percutaneous surgery for mild to moderate hallux valgus. Foot Ankle Clin. 2016;21(3):459-477. doi:10.1016/j.fcl.2016.04.001 (76% Smaller Incisions)
Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 2010;3:21. Published 2010 Sep 27. doi:10.1186/1757-1146-3-21
DiDomenico LA, Wargo-Dorsey M. Lapidus Bunionectomy: First Metatarsal Cuneiform Arthrodesis. McGlamrys Comprehensive Textbook of Foot and Ankle Surgery. 4th; p. 322-330.
Yamamoto Y, Yamaguchi S, Muramatsu Y, et al. Quality of Life in Patients With Untreated and Symptomatic Hallux Valgus. Foot Ankle Int. 2016;37(11):1171-1177. doi:10.1177/1071100716655433
Gribbin CK, Ellis SJ, Nguyen J, Williamson E, Cody EA. Relationship of Radiographic and Clinical Parameters With Hallux Valgus and Second Ray Pathology. Foot Ankle Int. 2017;38(1):14-19. doi:10.1177/1071100716666562
Cronin, S., Conti, M., Williams, N., & Ellis, S. J. (2020). Relationship Between Demographic and Radiographic Characteristics and Second Ray Pathology in Hallux Valgus Patients. Foot & Ankle Orthopaedics. https://journals.sagepub.com/doi/full/10.1177/2473011420909088
Lai, M. C., Rikhraj, I. S., Woo, Y. L., Yeo, W., Ng, Y. C. S., & Koo, K. (2018). Clinical and Radiological Outcomes Comparing Percutaneous Chevron-Akin Osteotomies vs Open Scarf-Akin Osteotomies for Hallux Valgus. Foot & Ankle International, 39(3), 311–317. https://journals.sagepub.com/doi/10.1177/1071100717745282
Peterson KS, McAlister JE, Hyer CF, Thompson J. Symptomatic Hardware Removal After First Tarsometatarsal Arthrodesis. J Foot Ankle Surg. 2016;55(1):55-59.doi:10.1053/j.jfas.2015.06.001
Prieto-Diaz, C., Anderle, M. R., Brinker, L. Z., Allard, R., & Leasure, J. (2019). Biomechanical Comparison of First Tarsometatarsal Arthrodesis Constructs Over Prolonged Cyclic Testing. Foot & Ankle Orthopaedics. https://journals.sagepub.com/doi/10.1177/2473011419892240