Help Notes for Nurses No. 3 -- Bunions (Hallux Valgus)
What are bunions?
• A bunion (known medically as “hallux valgus”) is a boney protrusion on the inside of the first metatarsal, causing the big toe to point towards the other toes.
▼ Why do bunions need nurses' attention?
• Treating bunions should be part of nurses’ foot health assessments designed to prevent or reduce foot problems that can seriously impair quality of life.
• Nurses are important in the post-operative care that follows surgery that removes bunions.
• Because nursing is a profession that involves long hours standing, nurses need to be mindful of the need for early attention to bunion development that might eventually impair their performance. They need to be well informed about preventive and corrective measures.
▼ How common are bunions?
• According to a 2012 article in the Journal of Clinical Nursing (see References below), hallus vargus is one of the more prevalent among foot problems. However, the article does not cite a prevalence rate.
▼ What are bunions’ core features?
• Callous forms on the skin at the inside edge of the big toe, and may become inflamed
• There is pain at the joint, especially with shoes, and the big toe skin may be discoloured and tender
• The first metatarsal shifts sideways as the bunion deformity grows, and the second toe may be pushed out of its normal alignment
• As the condition worsens walking becomes more difficult, the pain may become chronic, leading to arthritis.
▼ What are some its predisposing factors?
• Wearing shoes that are too small or have pointed toes.
• Having a family history of presence of bunions.
• The foot type inherited and the nature of the gait.
▼ What are the available treatment strategies?
• Wear shoes that are wide at the toes and the instep
• Wear pads on your that cushion the bunion
• Around the home keep the toes exposed to air, rather than covered by a shoe
• Use a warm foot bath to help relieve pain and discomfort.
• An orthotist can prescribe specially designed shoes that will reduce the pressure on affected joints and promote better toe alignment
• Surgery (bunionectomy) can realign the toes and removes the bump. Post-surgical recovery can be long and there may b recurrent swelling and stiffness, and there may complicatrions following surgery.
• Stolt M, Suhonen R, Puukka P, Viitanen M, Voutilainen P, Leino-Kilpi H. Foot health and self-care activities of older people in home care. Journal of Clinical Nursing. 2012 Nov;21(21-22):3082-95. doi: 10.1111/j.1365-2702.2012.04223.x. Epub 2012 Jul 27. (Abstract retrieved at http://www.ncbi.nlm.nih.gov/pubmed/22835017)
• Crista J Frank, DPM; Chief Editor: Jason H Calhoun, MD, FACS.
• WebMD. Bunions: Picture, symptoms, diagnosis, treatment and prevention. http://www.webmd.boots.com/foot-care/bunions-symptoms
• University of Maryland Medical Center. Bunions. http://umm.edu/health/medical/ency/articles/bunions#ixzz3VkKMGznP
• Wexler D, Grosser DM, Kile TA. Bunion and bunionette. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation . 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 76.
• Oliva F1, Longo UG, Maffulli N. Minimally invasive hallux valgus correction. Orthop Clin North Am. 2009 Oct;40(4):525-30, x. doi: 10.1016/j.ocl.2009.06.005.
Reference texts are copied verbatim from their sources.
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About Bunions (Hallux Valgus)
A Help Note for Nurses
by Foot Care Academy
© 2014 by Foot Care Academy, all rights reserved