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A bunion is enlargement of bone or tissue that develops at the joint that connects your big toe to your foot. The bones, muscles, ligaments and tendons of your feet normally are well-balanced to distribute your body's weight while standing, walking and running. When the joint, called the metatarsophalangeal joint, or MTP joint, experiences abnormal, prolonged stress in terms of weight distribution or squeezing of the toes within the shoe, the result can be the deformity called a bunion. Generally, a bunion develops when, as a response to prolonged stress, your big toe begins bending toward your foot's smaller toes and puts pressure on your MTP joint, forcing it to bulge outward (the term "bunion" comes from the Latin word for "enlargement"). There is no "standard" bunion, however, but rather a complex range of joint, bone and tendon abnormalities that can cause variation in each bunion's make-up.

Causes
The exact cause of bunions is unknown, but they tend to run in families. Wearing badly fitting shoes is thought to make bunions worse. It's also thought that bunions are more likely to occur in people with unusually flexible joints, which is why bunions sometimes occur in children. In some cases, certain health conditions, such as rheumatoid arthritis and gout, may also be responsible.

Symptoms
The major symptom of bunions is a hard bump on the outside edge of the foot or at the base of the big toe. Redness, pain and swelling surrounding or at the MTP joint can also occur.

Diagnosis
A thorough medical history and physical exam by a physician is necessary for the proper diagnosis of bunions and other foot conditions. X-rays can help confirm the diagnosis by showing the bone displacement, joint swelling, and, in some cases, the overgrowth of bone that characterizes bunions. Doctors also will consider the possibility that the joint pain is caused by or complicated by Arthritis, which causes destruction of the cartilage of the joint. Gout, which causes the accumulation of uric acid crystals in the joint. Tiny fractures of a bone in the foot or stress fractures. Infection. Your doctor may order additional tests to rule out these possibilities.

Non Surgical Treatment
There are two ways to treat this pathological foot conditions, conservatively and surgically. Conservative treatment is the first line treatment which consists of splints and orthotic care to reduce the causative factors. Realigning the foot with the aid of an orthotic helps prevent further degeneration and/or reduce symptoms of HAV in any stage of its deformity. Along with orthotic care, patients may require debridement of corns and calluses produced due to extra forces produced on the foot. Orthotics will also help the function of the big toe joint as it allows it to bend in the correct position. Footwear advice is also essential in the conservative care of bunions, HAV, there may be a need to change footwear, so it is able to fit properly and be compliment with orthotics. Surgical correction of bunions, HAV is available, however should only be considered when conservative care has failed to reduce the onset of bunions, HAV. It is only considered if there is a clear sign that it will induce a better quality of life for the patient.

Surgical Treatment
The most significant portion of the bunion surgery is re-aligning the bones. This is performed though bone cuts or a fusion involving the first metatarsal. The severity of the bunion determines where the bone will be cut or fused. Mild or moderate bunions can be corrected close to the big toe joint. Moderate or large bunions often require that the bone work be performed further away from the big toe joint to swing the bone in the proper position.

Prevention
Shoes that possess tapering toe boxes should be avoided if you have a bunion, as narrow toe boxes will hasten the progression of your bunion deformity. In some cases, conservative measures, including switching to appropriate footwear, may not have the desired effect, and your podiatrist may recommend for you a surgical procedure known as a bunionectomy. ]]> https://ameblo.jp/giselabierl/entry-12040191448.html Thu, 18 Jun 2015 05:13:27 +0900 Overview
A bunion (also called Hallux Valgus) is a painful swelling caused by deformity of the big toe. As this swelling is caused by a bone it can be very unforgiving in shoes, which can rub on it causing pain, particularly formal foot shoes or high heels. Arthritis, or wearing tight or ill-fitting shoes over a period of many years, may increase the risk of bunions. However, they can have other causes. Bunions are more common in women and sometimes run in families.

Causes
A bunion is more common in women than men due to women wearing tighter fitting shoes. This condition can cause a variety of different soft tissue and bony complaints which may result in severe pain.

Symptoms
If you have a bunion, you may have pain or stiffness of your big toe joint, swelling of your big toe joint, difficulty walking, difficulty finding shoes that fit. These symptoms may be caused by conditions other than bunions, but if you have any of these symptoms, see your doctor.

Diagnosis
Bunions are readily apparent - the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don?t go away, and will usually get worse over time. But not all cases are alike - some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.

Non Surgical Treatment
Padding with a number of different materials (eg felt) to reduce pressure on the painful prominence of the bunion. Physical therapy can be used to help with the symptoms and improve the range of motion (this is particularly helpful if the pain is coming from inside the joint, rather than from shoe pressure). Manipulation of the joint can be used to help with this (manipulation will never correct the alignment of the joint). Any corns and calluses that are causing symptoms should be treated. The correct fitting of footwear is essential for anyone who is serious about doing something about their bunions and hallux valgus. It may be possible to have your shoes stretched over the area of the bunion to also relieve pressure. Foot orthotics may be useful in helping with the instability about the joint. They may be more helpful if there are other symptoms in the foot as well, as their use in "treating" bunions is controversial. They may play a role in slowing progression and in the prevention of bunions developing again after surgical correction. Exercises can be important in maintaining the mobility of the joint in those with bunions, this is especially important for the arthritic type pains that may be originating from inside the joint and for the prevention of these painful symptoms in the future.

Surgical Treatment
This involves surgically correcting the deformity and can involve a variety of different methods. However, outcomes can be variable. This is very dependant of the amount of damage to the joint and the procedure used to correct it. Removal of the bunion is performed using different methods that are out of the scope of this article. Unfortunately, bunions can recur following surgery, and even if it surgery is successful, around 30% of patients still report existing difficulties. ]]> https://ameblo.jp/giselabierl/entry-12036752149.html Tue, 09 Jun 2015 08:04:38 +0900 Overview
Achilles Tendon Rupture Surgery is a surgical procedure is used to repair a ruptured Achilles tendon. There are two types of surgery an open surgery and a percutaneous surgery, in both cases the surgeon sews the tendon back together through the incision helping the tendon to heal properly and restore function to the foot and ankle. If the injury or rupture has caused severe swelling the surgery may be delayed for a short period of time to allow the swelling to go down.

Causes
An Achilles tendon rupture is often caused by overstretching the tendon. This typically occurs during intense physical activity, such as running or playing basketball. Pushing off from the foot while the knee is straight, pivoting, jumping, and running are all movements that can overstretch the Achilles tendon and cause it to rupture. A rupture can also occur as the result of trauma that causes an over-stretching of the tendon, such as suddenly tripping or falling from a significant height. The Achilles tendon is particularly susceptible to injury if it is already weak. Therefore, individuals who have a history of tendinitis or tendinosis are more prone to a tendon rupture. Similarly, individuals who have arthritis and overcompensate for their joint pain by putting more stress on the Achilles tendon may also be more susceptible to an Achilles tendon rupture.

Symptoms
Patients with an Achilles tendon rupture frequently present with complaints of a sudden snap in the lower calf associated with acute, severe pain. The patient reports feeling like he or she has been shot, kicked, or cut in the back of the leg, which may result in an inability to ambulate further. A patient with Achilles tendon rupture will be unable to stand on his or her toes on the affected side.

Diagnosis
In diagnosing an Achilles tendon rupture, the foot and ankle surgeon will ask questions about how and when the injury occurred and whether the patient has previously injured the tendon or experienced similar symptoms. The surgeon will examine the foot and ankle, feeling for a defect in the tendon that suggests a tear. Range of motion and muscle strength will be evaluated and compared to the uninjured foot and ankle. If the Achilles tendon is ruptured, the patient will have less strength in pushing down (as on a gas pedal) and will have difficulty rising on the toes. The diagnosis of an Achilles tendon rupture is typically straightforward and can be made through this type of examination. In some cases, however, the surgeon may order an MRI or other advanced imaging tests.

Non Surgical Treatment
Once a diagnosis of Achilles tendon rupture has been confirmed, a referral to an orthopaedic specialist for treatment will be recommended. Treatment for an Achilles tendon rupture aims to facilitate the torn ends of the tendon healing back together again. Treatment may be non-surgical (conservative) or surgical. Factors such as the site and extent of the rupture, the time since the rupture occurred and the preferences of the specialist and patient will be considered when deciding which treatment will be undertaken. Some cases of rupture that have not responded well to non-surgical treatment may require surgery at a later stage. The doctor will immobilise the ankle in a cast or a special hinged splint (known as a ?moon boot?) with the foot in a toes-pointed position. The cast or splint will stay in place for 6 - 8 weeks. The cast will be checked and may be changed during this time.

Surgical Treatment
Your doctor may recommend surgery if you?re young and active, or an athlete. However, this will depend on where your tendon is ruptured. If the rupture is at, or above, the point at which your tendon merges with your calf muscle, for example, surgery may not be possible. There are three main types of surgery to repair a ruptured Achilles tendon. Open surgery. Your surgeon will make one long cut in your leg to reach the tendon and repair it. Limited open surgery. Your surgeon will still make a single cut but it will be shorter. Percutaneous surgery. Your surgeon will make a number of small cuts to reach the tendon and repair it. In all types of surgery, your surgeon will stitch the tendon together so it can heal. Each type of surgery has different risks. Open surgery is less likely to injure one of the nerves in your leg for example, but has a higher risk of infection. Ask your surgeon to explain the risks in more detail. After your operation, you will need to wear a series of casts or an adjustable brace on your leg to help your Achilles tendon heal. This will usually be for between four and eight weeks. There is a chance that your tendon will rupture again after the operation. ]]> https://ameblo.jp/giselabierl/entry-12021609568.html Sat, 02 May 2015 16:20:02 +0900