Hello, I am Dr. Premkumar, diabetic foot surgeon. Today’s video is all about a bunion. A bunion is usually shared among females, mainly in females who are very much worried about the cosmetic dysfunction of the Victor. Sometimes it causes pain also for the patient, and arthritis develops at the bunion joint, so they will come to a podiatrist or auto prediction for a treatment.
What is the bunion? The angle of the Victo bisecting the first meta tracing as well as the proximal phalanx. It should usually be less than 15 degrees. If it is more than 15 degrees, it is abnormal and if it goes more than 40 degrees if it is a severe bunion. So when we come for assessment of the bunion, the assessment usually not only assessing the big toe patient has to be assessed for data analysis, they have to check for whether they have a flat foot or there is any ligamental laxity at the torso.
Metatarsal and the metatarsal Valencia joint have to be examined, and the tightness of the tendon list has to be accessed. And the family history is also essential when it comes to aetiology, which is a constituent factor. There are extrinsic causes as well as intrinsic causes. Extrinsic causes usually wear tight footwear, and crowded footwear make the bullion worse or high heel footwear.
And then, when it comes to intrinsic factors, gene plays an important role in having a bunion. It sometimes runs in families also and then type Tendo, Achilles and pissed planners. That is, a flat foot and ligamental lacsitivity are all intrinsic factors contributing to developing a bunion. So if somebody notices bunion, they need to immediately visit a podiatrist or an auto podiatrition. So first, the management of bunion is surgical as well as non surgical.
If it is a mild, moderate bunion without any rigidity at the microsphere and the joint, this can be managed conservatively conservative management usually teaching the patient physiotherapy and then exercise and then advising the patient a custom insoles to support the medial actual of the foot and then stretching exercise. If there is too much tightening of the Tendo, at least all these things. If the patient is having severe pain at the bunion inside, they can use ice packs and then rest the joint for a few days so that the information subsidies.
When it comes for conservative management, I will teach you the exercise regimen. We usually teach the patient three exercise for a mild and moderate bullion.
After the exercise is short foot exercise, so short foot exercise they have to increase the Dome that is height of the medial art.like this.The height of the medial art should be raised. This has to be done 20 times.
The muscles which is activated by this short foot exercise is abductor hallucist, longest abductor digital minimize and then flux our digital one so the three muscles are usually activated. In this short footage exercise. I’ll repeat it again. The object are halosis longest and the abductor digital activated in this exercise and the second one is toe playing. So you see the toe is spreading out so this has to be repeated 20 times like this.
This also activates abdicolysis and the abductor digital memory. These three muscles are activated in this toe spread out excess, so this has to be repeated. Both of it has to be done. The exercise has to be done on both the feet Alternatively, so we can use any brand. So this is a hairband.
This has to be a patient has to sit and then this has to be put and in between grey toa has to be stretched like this and relaxed.So this has to be done every day 20 times. If they want, they can lift the foot also from the ground, keeping the heel in the ground.
So this has to be repeated every day and then if they have a tiny Centaur calf muscles, this has to be stretched with a towel. The patient should feel the pain and this cough muscle and this has to be done ten times. Plus, if they don’t have this art very large, this has to be supported with the customer source. So the exercise sometimes the patient, if they have severe pain, bunion are available, which each holds the great or this position throughout the night and it reduces the pain.
So Bunion and splinter commercially available in the market can purchase this one that has to be fixed here, which will hold the grey toe in position throughout the night.
So these things are conservative management when it comes to bunion management and surgical management. Usually, if the patient develops long term chronic arthritis and the pain, we can suggest the patient’s surgical approach. There are a few surgical methods usually we do at our operation centre. Few agents are surgical procedures. The postoperatively.
The patient needs one month’s rest, and following that, they can get back to normal with excellent spacious front footwear, so they won’t be advised to wear crowded footwear or pointed footwear for at least six months. Surgical management is usually recommended when the patient develops arthritis at this point and pain because of arthritis. And as I told three surgical procedures, we commonly do it here, so the post-operative follow up will take one month. So after that, the patient can walk with the particular footwear.
So this is all about bunion Thanks for watching. Bye.