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Foot Problems: Bunions

A Bunion (excess or misaligned bone in the joint) is one of the most common big toe problems. In addition to causing pain, a bunion changes the shape of your foot, making it harder to find shoes that fit. Bunions usually occur at the base of the big toe. They are often caused by incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. In some cases, joint damage caused by arthritis oran injury produces a bunion. Some people are just born with an extra bone near a toe joint.

  • Positional Bunion: arise from the growth of new bone.
  • Structural Bunion: results when the joint at the base of the toe shifts position.


If a bunion is not severe, our doctors may recommend that you wear a different style of shoes. Or you may be prescribed custom-made shoe-inserts (orthoses) to control incorrect foot mechanics. For severe bunions, outpatient surgery may be recommended.

Shifting Soft Tissue

To realign the affected joint, any tight tendons on the inside of the toe are released. New bone that makes up the bunion is shaved away.

Shifting Bone

The most common bunion surgery reduces the angle between the first and second toes. Bones in the big toe are realigned and the bunion is shaved away. Ligaments and tendons on the outside of the toe may be tightened to hold the joint properly.

Removing Bone

If a structural bunion is severe, a piece of bone is removed from the first metatarsal (the long bone behind your big-toe joint). Once repositioned, this bone may be held in place with a pin or a screw. Any new bone that makes up a bunion is shaved away.