From Etiology to Intervention: A Holistic Review of Bunion Pathophysiology and Care

Abstract

In this review paper, we present the common etiology, presentation, diagnosis, and management of the following three common bunion formations: dorsal bunion, tailor's bunion, and hallux valgus (HV). Bunions are common pathologies that present to a variety of clinics, so it is important for providers to have a base understanding of these in order to provide the best care to patients. Many of these bunion formations have a variety of causes which allow providers to manage them before surgical intervention is required. The aim of this review paper is to bring attention and expanded insight on these common bunion presentations in order to minimize morbidity early on. The information provided in this review will allow both primary care and subspecialty physicians with the knowledge to accurately diagnose and optimally manage these bony deformities of the lower extremity.

Figure 1

X-ray of the left foot, showing the horizontal alignment of the first metatarsal, flexion of the first MTP and an extension of the IPP joint of the hallux [2].

Figure 2

Table summarizing the causes, conditions, outcomes and treatment options of dorsal bunions.

Figure 3

A. 4-5 metatarsal angle; B. lateral deviation angle [26].

Figure 4

Radiologic assessment and presentation of hallux valgus angles. Demonstrating the various angles: intermetatarsal angle (IMA), dorsal metatarsal angle (DMAA), and first metatarsophalangeal angle, also known as hallux valgus angle (HVA) [39].