Self-Assessment Quiz

A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes . The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Varus. Bunions can also lead to other toe deformities, such as hammertoe.

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult--all contributing to chronic pain.

Bunions have been with mankind since the beginning of time. Undoubtedly they have received more attention since shoes have become a vital part of our fashion. It is generally recognized that those who have a bunion deformity most probably inherited the tendency from an earlier generation. So often people are told "don't have anything done until you can't stand the pain"! This is a misconception! Our rule of thumb is that when it becomes obvious that you have a bunion, that is the time to correct it!

Treatment for Bunions

Certainly the goal in bunion treatment is to limit the deformity and to stop the progression if it has already begun. This can only be done in the very beginning stages. When it is seen that the deformity is beginning in children and young adults, often the use of a good custom orthotic will stop the progression of the deformity. Also wearing shoes that do not irritate the deformity is also wise.

Surgical Treatment

The greatest hurdle that people with bunion deformities have to overcome is history. In most instances, these people have had a relative with the same deformity who years ago had surgery and they remember the pain and the weeks and months in casts and on crutches. They also remember that after going through all of this pain and suffering, in many instances the bunion came back.

The good news is that in the past 10 years new techniques and better instrumentation have been developed. Bunion correction of today involves the use of micro instruments with precise cuts in the bone to correct the deformity, thus limiting the rate of re-occurrence. The old days of the doctor saying "I'm going to have to break the bone and reset" it are gone. If anyone says that to you, run as fast as you can! Gone are the days of casts and crutches and wheel chairs post-operatively. Only in the most severe cases must the patient be "non-weight bearing". In most cases, the patients at the Ford Center can resume a fairly normal lifestyle in days or weeks rather than months.

At the Ford Center for Foot Surgery, the procedures are done with I.V. sedation administered by one of our qualified anesthesiologists. We also use a regional anesthetic which is much safer than a general anesthetic. We can do this because we do not use tournequets when we do foot surgery. This minimizes post operative pain as well as the risk of blood clots. The net result of this is that the patient is awake and can walk within minutes following the surgery but their foot is numb for 18 - 20 hours.

The procedure itself is accomplished through an incision on the inside of the foot, thus there are no unsightly scars. The capsule of the joint is exposed and is opened revealing the "bump" on the side of the metatarsal bone. The over growth of bone is removed. Next a very precise "V" cut is made in the bone from one side to the other and the end or head of the bone is moved over. This narrows the foot back down to its normal width. To maintain this, a small screw is placed in the bone to secure the correction. The skin and soft tissues are then sutured and the foot bandaged. The foot is then placed in a post op shoe that will be worn for several weeks.

As a general rule, our patients return to comfortable shoes in 2 to 3 weeks.

The Foot Health Foundation of America offers this simple quiz to pinpoint any warning signs of foot and ankle problems: (See bottom for scoring.)

1.
 
How much time do you spend on your feet each day?
 
  a. less than 2 hours 0
  b. 2 - 4 hours 1
  c. 5 - 7 hours 2
  d. 8 hours or more 3
 
 
2.
 
How old are you?
 
  a. under 40 0
  b. between 40 and 59 1
  c. 60 and over 2
 
 
3. How would you describe your weight?  
  a. less than 20 pounds overweight or at ideal weight 0
  b. 20 - 39 pounds overweight 2
  c. 40 or more pounds overweights 3
 
 
4. Have problems with your feet or ankles ever prevented you from participating in:  
  - leisure/sports activities  
  a. yes 2
  b. no 0
  - work activities?  
  a. yes 3
  b. no 0
 
 
5. Have you ever received medical treatment for problems with your feet and/or ankles?  
  a. yes 3
  b. no 0
 
 
6. Do you regularly wear heels two inches or higher?  
  a. yes 2
  b. no 0
 
 
7. What types of exercise do you engage in or plan to engage in? (check all that apply)  
  a. walking 1
  b. field sports (e.g., softball, golf) 2
  c. winter sports (e.g., skiing, ice skating) 2
  d. court sports (e.g., tennis, basketball) 3
  e. aerobics 3
  f. running 3
  g. none (if you shose answer g, skip to question 11) 0
 
 
8. Do you have the appropriate shoes for your sport or sports?  
  a. yes 0
  b. no 3
 
 
9. Do you experience foot or ankle pain when walking or exercising?  
  a. rarely 1
  b. sometimes 2
  c. often 3
  d. never 0
 
 
10. Do you:  
  - exercise in footwear that is more than one year old or in hand-me-down footwear?  
  a. yes 3
  - stretch properly before and after exercising?  
  a. yes 0
  b. no 3
 
 
11. Do you:  
  - have diabetes?  
  a. yes 3
  b. no 0
  - experience numbness and/or burning in your feet?  
  a. yes 3
  b. no 0
  - have a family history of diabetes?  
  a. yes 2
  b. no 0
 
 
12. Do You: (Mark all that apply)  
  - sprain your ankles frequently (once a year or more) or are your ankles weak?  
  a. yes 2
  b. no 0
  - have flat feet or excessively high arches?  
  a. yes 2
  b. no 0
  - experience pain in the achilles tendon or heel or have shin splints
(pain in the front lower leg)?
 
  a. yes 2
  b. no 0
  - have corns, calluses, bunions or hammertoes?  
  a. yes 3
  b. no 0
  - have arthritis or joint pain in your feet?  
  a. yes 3
  b. no 0
  - have poor circulation or cramping in your legs?  
  a. yes 3
  b. no 0

 

Scoring

0-20 Points: Congratulations! Your feet and ankles are very healthy and you can maintain your active lifestyle and/or exercise regimen. With proper attention and care your feet and ankles should remain healthy; however, you may want to schedule an annual exam with a podiatric physician to ensure their long-term health. Furthermore, if you scored points for questions 4, 5, 9, 11 or 12 you should consider visiting a podiatric physician in the near future for a check-up.

21 - 40 Points: Pay Attention. Your feet and ankles are showing signs of wear, placing you in the moderate risk category. Although you can continue your normal activities, you should strongly consider visiting a podiatric physician for a check-up. If you participate in a rigorous exercise regimen on a regular basis or plan to - or if you scored points for questions 4, 5, 9, 11 or 12 - you should visit a podiatric physician soon to safeguard your foot and ankle health.

41 Points or Higher: Caution. Your feet and ankles are at high risk for long-term medical problems and you should contact our office as soon as possible. If you exercise, you should pay particular attention to your feet and ankles until you are seen by our practice. If you have not begun exercising, it is advisable to contact our office before undertaking any type of exercise.

Now that you've assessed the health of your feet and ankles, you are armed with knowledge that will enable you to maintain their health over a lifetime.

Please note: Even if you scored well, this self assessment is not a substitute for a physical exam.