Common Problems of the Great Toe
It is not called the "great toe" for nothing. This area of the foot supports upto 50% of the body's weight during walking. It is then no surprize then that it can suffer more problems then just a "bunion" (hallux valgus). And not all of its problems are due to shoewear.
Hallux Valgus a.k.a ."Bunion"
Common deformity of the big toe. Can come on with age or be inherited or both. Initial treatment is wearing shoes that fit. Night splints that stretch them out can help or prevent progression. Surgery is best for those with painful deformities,progressive deformities, big toe bullying the 2nd and third toes over and increasing difficulty in finding shoes that fit. Cosmetic correction surgery for people with no complaints (other than looks) has a sucess rate of only 65%. Where as, more symptomatic "bunions" have a sucess rate over 90% with the appropriate surgery. Not all bunions are alike so what happened to one of your friends does not neccessarily apply to you!!!
There are over 140 different procedures in the literature to correct a bunion deformity. Which one is best for you is dependent on your symptoms and the amount of deformity present and whether there is any arthritis or underlying ligamentous laxity. It is up to the orthopedic foot specialist to determine with you which set of procedures is most likely to address your deformitis and relieve your symptoms as well as give you the best chance of avoiding a recurrence.
In general, correction of your bunion is performed as an out patient procedure under ankle block anesthesia. Whether you are allowed to put weight on the foot immediately aftereward depends on what is done to correct the deformity.With just "Cutting the bump off" and soft tisse procedures usually allows one to weight bear in a post-op shoe or brace immediately. Elevation of the foot higher then the heart for the first 2-3 days phelp reduce the swelling associated with the surgery
(which may remain for months!). Certain deformities require cutting of the bones involved or a fusion of a joint. In these cases you may be placed in a splint or a cast for 2-4 weeks before youare allowed to put weight on the foot.
Regardsless the pain after a foot surgery lasts for 3-7 days and tapers off with time. Most people can exxpaect to be fully weight earing by 4-6 weeks in the worse case scenario. You can expect to be able to fit into a lace up shoe as early as 7-8 weeks after the surgery, depending on swelling.
Hallux Rigidus or dorsal bunion is a essentially a stiff painful great toe. It can come on with age or be due/aggravated by an injury, the end result is a toe that is stiff and may hurt in some or all shoes. It is particularly distressing in woman who want to wear heels and tight shoes . Roomy shoes with soft material (e.g. jogging shoes) almost always feel best. The cause of the problem is arthritis of the joint. Fortunately it is a process that slowly develops. There are many treatments from changes in shoe styles, to orthotics, injections and ultimately surgery.
Dr Sheskier has developed a technique for severe hallux rigidus that allows motion of the toe for cases that otherwise would require a fusion.
***Information provided by the American Orthopedic Foot and Ankle Society