Hallux Valgus (Bunion), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
()
About this ebook
Hallux Valgus (Bunion) is the medical disorder that cause deformity of the big toe metatarsopharyngeal (MTP) joint in which there is medial enlargement and lateral deviation of the big toe.
This is normally linked with bony and connective tissue enlargement of the medial aspect of the first metatarsal head that is called the bunion.
A hallus valgus (bunion) forms when the big toe points toward the second toe.
This produces a bump to occur on the inside edge of the toe.
The source is lateral deviation of the great toe so as to put a valgus deformity on the first metatarsophalangeal (MTP) joint.
A deviation of 15-20° is regarded abnormal.
This deviation affects the biomechanics of the foot.
It may induce subluxation of the first MTP joint and the big toe may even cover the second toe.
Lateral subluxation induces a prominence on the metatarsal head (bunion) often followed by the formation of a fluid-filled bursa.
This becomes painful as it scrapes against the shoe.
Shoe wear does not cause hallux valgus.
Hallux valgus can happen as a result of:
1. Heredity
People born with abnormal bones in their feet are more prone to form a bunion.
2. Flat foot (pes planus)
3. Metatarsal primus varus
4. Hyper mobile first metatarsal cuneiform joints
5. Abnormal length of first metatarsal
Tight shoes can produce pain and nerve entrapment in link with hallux valgus.
Symptoms:
1. Normal inter-metatarsal angle (the angle between the first and second metatarsals is 9 degrees or less).
The normal first MTP joint angle is less than 15 degrees.
2. Any increase of 15 degrees angle is regarded as lateral deviation of the first metatarsopharygeal joint.
3. The big toe is turned inwards towards the second inducing a medial protrusion of the MTP joint called a bunion which can become inflamed and tender.
4. There is red, thickened skin along the inside edge of the big toe forming a bony bump at this location.
5. In severe cases the first toe can overlap the second toe or the second toe may cover the in-turned big toe. The big toe is turned toward the other toes and may cross over the second toe
X-rays reveal the presence of lateral deviation of the proximal phalanx and the presence of a medial exotosis.
When a bunion first starts to form, good care of the feet should be taken.
Wide-toed shoes should be worn.
This can often resolve the pain and avoid the patient from requiring more treatment.
The felt or foam pads on the foot are used to protect the bunion, or devices called spacers to separate the first and second toes.
Cutting a hole in a pair of old, comfortable shoes to wear around the house helps.
If the hallux valgus worsens and more painful, the surgery may help to realign the toe and remove the bony bump (bunionectomy).
The result of conservative treatment is so poor that surgery may be a useful method of treatment.
Surgery may be delayed without an adverse effect on the final outcome, even though pain and patient satisfaction are reduced with early surgery.
The simplest way is the removal of the bony prominence (exostectomy).
Otherwise, Keller's arthroplasty affects producing a flexible joint by removal of the medial part of the metatarsal head together with some of the proximal phalanx.
Arthrodesis of the joint may be done.
TABLE OF CONTENT
Introduction
Chapter 1 Hallux Valgus
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Overlapping Small Toe
Chapter 8 Hammertoes
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Hallux Valgus (Bunion), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Hallux Valgus
(Bunion),
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2016 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes the Hallux Valgus, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What You Need to Treat Hallux Valgus)
This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Conditions
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical conditions.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Hallux Valgus
My mother had hallux valgus (bunion) of her right foot since the age of fifty.
Her big toe was bending towards her second toe and overlapped it.
It was probably painful but she never allowed us to help her.
She had special shoes to wear to fit her foot.
It is also possible when she was small her mother forced her to bind her foot so that it look small and dainty as was the case in many Chinese women around her time.
However I believed that it was most genetic because at the age of forty my elder brother also had hallux valgus and had an operation to correct it.
My second brother and myself do not have the hallux valgus.
What is Hallux Valgus?
Hallux Valgus (Bunion) is the medical disorder that cause deformity of the big toe metatarsopharyngeal (MTP) joint in which there is medial enlargement and lateral deviation of the big toe.
This is normally linked with bony and connective tissue enlargement of the medial aspect of the first metatarsal head that is called the bunion.
A hallus valgus (bunion) forms when the big toe points toward the second toe.
This produces a bump to occur on the inside edge of the toe.
The source is lateral deviation of the great toe so as