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Blog

Jan 13

Written by: Larry Huppin, DPM
1/13/2011 8:39 PM

Clinical Goal for Orthoses Following Bunion Surgery:
Following a bunion procedure, our primary goal with orthotic therapy is to encourage full range-of-motion in the first metarsophalangeal joint .

Biomechanical Goal:
To encourage first MPJ full range of motion, we wish to decrease excessive ground reactive force under the first ray and to allow the first ray to plantarflex. The orthosis should be designed to decrease the everted position of the calcaneus when an everted rearfoot is present. In the case of an everted forefoot, the orthosis should support the lateral forefoot (forefoot valgus).

Prescription:
The ProLab Hallux Limitus Pathology Specific Orthosis will accomplish this goal. To prescribe it, simply check off “Hallux Limitus” in the Pathology Specific portion of the prescription form.

Surgical Biomechanical Complications
There are a number of potential biomechanical complications following bunion surgery. For example, shortening of the first metatarsal can lead to lesser metatarsal head metatarsalgia. If any complication is present, the recommended orthotic prescription may change substantially. If so, we recommend a call to one of our medical consultants while writing the orthotic prescription. This service is available to ProLab clients only.

Summary
The orthosis for patients after bunion procedures is based on the literature (see references). It acts to decrease functional hallux limitus by promoting first ray plantarflexion, reducing compression in the 1st MTP joint, and improving hallux range of motion.

Related Reading
Understanding the Biomechanical Effects of Hallux Limitus
by Paul R. Scherer, DPM

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