Note hallux valgus — Chapter XXVII · THE SKIN.

[22] The Radical Cure of Bunions.—The term bunion is generally used to indicate a painful swelling over the inner aspect of the ball of the great toe; it is never seen on the feet of those who go barefooted, but is the result of badly fitting shoes, almost all of which crowd the great toe outward, thus making its base more prominent and exposing it to irritation and pressure. The inner border of the foot is nearly a straight line, but shoes are rarely made to conform to this. The result of the consequent partial dislocation of the toe, and of the pressure made at its base, is chronic periostitis, and the development of a bursa. It becomes greatly thickened and forms a small tumor, usually sensitive and painful. The dislocation often proceeds to such a degree that the great toe lies across the others, either over them or under them, in such a position as to receive and deserve the name hallux valgus, which is generally given it when this is pronounced. There is nothing to do but to exsect the head of the first metatarsal bone, and at the same time excise the bursa and some of the overlying and thickened skin.