An x-ray must be taken to evaluate the bones in the foot and to determine the type of bunion that is present. Initial treatment of all bunions involves conservative care with modification of shoes to accommodate deformities. This may include the prescription of wider, deeper shoes or orthotics. Patients who fail to respond to conservative management can often be helped with surgical management. Bunions are placed into two categories, inherited and acquired.
Inherited bunions can require surgical reconstruction during the later stages of adolescence.
This can consist of removal of the bony bump with soft tissue correction alone or in combination with cutting and shifting of bone. Acquired bunions develop over time as a result of shoe wear. These can be corrected with soft tissue procedures alone, but more frequently require extensive bone and soft tissue work. This may require the use of screws and pins to stabilize the bone and may involve wearing a cast post-operatively. Severely deformed bunions which involve deterioration of cartilage may require fusion of the great toe to alleviate pain.