Foot and Ankle
Our feet and ankles are being used everyday for various daily activities. Hence, injuries to the foot and ankle are very common.
The ankle is made up of 3 bones that meet at the ankle joint: the tibia (shinbone), fibula (smaller bone of the lower leg) and talus (small bone in between the tibia and fibula and the calcaneus). The ankle joint where these 3 bones meet are encased by a joint capsule, which contains synovial fluid. This synovial fluid is important as it allows for smooth movement of the joints. The ankle is surrounded by ligaments, which help to stabilise it.
The foot is a complex structure of the body, consisting of 26 bones, 33 joints, 107 ligaments, and 19 muscles. The bones can be categorised into 3 sections:
The forefoot consists of your toes (phalanges) and metatarsals
The midfoot consists of bones that make up the arch of your foot
The hindfoot consists of the heel and ankle, where the talus and the calcaneus (heel bone) are found.
Muscles, ligaments and tendons in the foot help stabilise your foot and allow for complex movement and motions. As there are many bones in the foot, fractures can occur at many locations in the foot, such as toe fractures, metatarsal fractures or calcaneus fractures. Another type of fracture that can occur in your foot is a stress fracture, which develop due to stress overtime.
WHAT IS A BUNION?
A bunion, also known as hallux valgus, is a bony bump that forms on the joint located at the base of your big toe. This happens when the big toe is angled toward the second toe, creating the bony bulge. This angling of the big toe is mainly due to pressure, which causes a change in the bone structure of the big toe and resulting in a bunion. In some cases, another type of bunion called a bunionette can develop as well. A bunionette is a bony bump located at the joint of your little toe.
Bunions are very common, and anyone can get it.
WHAT ARE THE SYMPTOMS OF A BUNION?
One main symptom of a bunion is a bony bump on the joint at the base of your big toe.
Other symptoms of a bunion include:
- Pain, tenderness and swelling around your big toe joint
- Corns or calluses on the bump
- Difficulty wearing shoes with a tight toebox
- Limited range of motion of your big toe
WHAT ARE THE CAUSES AND RISK FACTORS OF BUNIONS?
Some causes and risk factors of bunions are:
- Wearing ill-fitting shoes (shoes are too tight or too narrow) increases your risk of developing bunions
- Wearing shoes with narrow toeboxes often, such as working females who often wear heels and dancers are at higher risk
- Heredity (you may inherit a foot shape and structure that is more prone to bunions)
- Foot injuries
- Inflammatory conditions such as rheumatoid arthritis
WHAT IS THE DIAGNOSIS OF A BUNION?
A history of the injury and a physical examination of the foot will be conducted by the Doctor.
Imaging tests will be taken, such as x-ray to check on the structure of your bones and the alignment of your toes, as well as the severity of your bunion.
WHAT ARE THE TREATMENT OPTIONS FOR A BUNION?
Nonsurgical treatment options to relieve the pain caused by a bunion includes:
- Changing your footwear to a comfier shoe, one with a bigger toebox
- Bunion pads
- Pain-relief medications such as acetaminophen
- Orthotics such as toe spacers or a splint worn at night
- Icing the area to reduce swelling
If nonsurgical treatment options fail to help your symptoms, and if the bunion is interfering with your everyday activities and causing pain, surgery may be recommended. One of the more popular surgical methods is minimally invasive bunion surgery.
During this procedure, a few tiny incisions will be made near the big toe. Tiny bone-cutting instruments will then be inserted to remove the excess bone and realign the toe to correct the deformity.
Minimally invasive bunion surgery is much better than the traditional surgery that was performed in the past, where a single long incision will be made instead of a few tiny incisions. Minimally invasive bunion surgery also reduces the risk of wound complications and wound healing problems compared to traditional surgery.