Dr Michael Perlstein, D.A.B.P.O. Podiatrist, Talks about Bunions
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Male Speaker: What is a bunion? Male Speaker: A bunion is a bony deformity on the feet, that can be either on the inside of the foot, that we call the first metatarsal head. And it could be on the fifth metatarsal head and what happens over a period of time is that the bone starts to protrude, the bone develops what we call some arthritis or some changes in the bone, and the bigger it gets, the harder it gets to fit into a shoe and it becomes uncomfortable sometimes, even without a shoe as the irritation in the arthritis develops and progresses. Male Speaker: What the most reason a person would get a bunion? Male Speaker: Most of the time it comes from what we call genetic factors, in combination with the way they are walking, such as what we call pronation of the foot. Shoe is obviously aggravate it. But most of it really comes from the way we are walking, which is what we call bi-mechanical. Male Speaker: Okay, if someone has a bunion and he came to you, how would you approach the problem? Male Speaker: Well, what we basically do is we evaluate them. We see how they're walking, we see how they are standing, we see how much the bones zig zag. We make sure there are no infections, or signs of some other injury in that area. We then have them walk for us, as I said, in our gait analysis. And then what we do is we take an x-ray to evaluate the situation of the bone, making sure that there is nothing else there besides the typical bunion. We rule out any gout, or arthritis, any bone scars. Sometimes we see a cyst or a tumor in that area. We also evaluate the soft tissue, with what we call an ultrasound. Sometimes they do need a CT scan or an MRI. Then we have our basic examination. We go through the variety of different treatment plans, ranging from what we call conservative care, like having them just change their shoes or perhaps making an insole, to let them walk a little straighter and better if it's a bio-mechanical problem. If it's already arthritic and it's really deformed, because its been there from a long period of time, these surgical actions are explained to the patient. They have to decide what they would like to do. Male Speaker: In other words, if you have it, there are many things you can do to relieve the situation. Male Speaker: Absolutely. It can be ranking from conservative care, through surgical.
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