Occasionally there are special indications. If the distal phalanx of the great toe is angled to lateral (hallux valgus interphalangeus), osteotomy of the proximal phalanx with removal of a medial-based wedge is required (generally in addition to one of the procedures described above) ( 8 ). Absolutely accurate restoration of the angle is not possible, but if the wedge has a base of 1 to 3 mm the correction is usually adequate. Complicated and costly implants (staples, screws) are available, but adequate fixation can be achieved with a simple, inexpensive suture threaded through drill holes. In the January’s issue of Orthopedics magazine there is a paper which presents the results of more widely used method of correction of hallux valgus – the so- called Scarf osteotomy. The authors, Aly TA, Mousa W. and Elsallakh S. analyze the results of surgery they performed even after 3 years. The assumptions characterizing this kind of operation are a few dozen years old. Nowadays, thanks to the availability of special equipment, it is possible to fully apply this treatment. As the authors say, the results are promising. Below is a hallux valgus deformity (blue arrow) with the big toe under lapping the second toe. HOW DOES IT OCCUR However, there is currently a dearth of investigation into the accuracy and reliability of this practice despite its acceptance among surgeons. In a study recently published in Skeletal Radiology, Ege et al. compared HV angle measurements conducted on the iPhone with those determined by computer software, which is currently accepted as the most accurate method. The authors note that subjectively, “iPhone measurements were faster and more practical than computerized measurements,” and can be “used for measurement of hallux valgus angles in clinical practice and even for research purposes. It is an accurate and reproducible method.” Bunions are sometimes genetic dubious – discuss and consist of certain tendons , ligaments , and supportive structures of the first metatarsal that are positioned differently. This bio-mechanical anomaly may be caused by a variety of conditions intrinsic to the structure of the foot – such as flat feet, excessive flexibility of ligaments, abnormal bone structure, and certain neurological conditions. These factors are often considered genetic Although some experts are convinced that poor-fitting footwear is the main cause of bunion formation, 4 other sources concede that footwear only exacerbates the problem caused by the original genetic structure. Many problems that occur in the feet are the result of abnormal pressure or rubbing. One way of understanding what happens in the foot due to abnormal pressure is to view the foot simply. Our simple model of a foot is made up of hard bone covered by soft tissue that we then put a shoe on top of. Most of the symptoms that develop over time are because the skin and soft tissue are caught between the hard bone on the inside and the hard shoe on the outside. A tailors bunion will generally only hurt in shoes and be fine barefoot, or in open shoes like a sandal. Orthoses — In the treatment of HV deformity, orthoses are used to improve foot mechanics (eg, reducing abnormal subtalar joint pronation) and to prevent abnormal forces from acting on the first ray complex. It is hoped that orthoses might prevent deterioration of the HV angle and relieve pain by improving joint function. Orthoses need to be worn in a well-fitting, low-heeled, fastening shoe, and this type of shoe may itself influence joint position and discomfort. Other — Marigold ointment was reported to be effective in reducing pain, soft tissue swelling, and the HA angle when applied to the bunion area over an eight-week period 42. Your feet take a pounding every day from walking,standing, exercise, working and shoes. When you add a foot disorder to theequation, each painful step reminds you of how much stress your foot takes. Arecent study by the American PodiatricMedical Association showed that there is a 75% chance ofyou having some type of foot aliment during your lifetime. While there arenumerous foot conditions, some conditions are much more common than others.Understanding these conditions and what you can do to help yourself can be thefirst step back towards a pain-free lifestyle. There are few self-treatment options for thiscondition, but here are a few things you can try on your own to help.