Are functional foot orthoses more beneficial before or after corrective surgery for bunion deformities?
Preoperatively, Dr. Kirby says orthoses can slow the progression of the deformity and decrease pain to the first MPJ. Dr. Blake says orthoses may be crucial in helping some patients avoid bunion surgery. He emphasizes the importance of obtaining a stable pre-op orthotic as there are many pitfalls with fit and shoegear. For example, Dr. Blake says one may discover preoperatively that the patient has nerve hypersensitivity secondary to Morton’s neuroma and cannot wear the orthotic. He points out that this finding could change the post-op choices if one notes these pre-op problems and completely addresses them. In Dr. Burns’ experience, HAV is influenced, if not caused, by abnormal function. However, he acknowledges there is mixed literature on the subject. Therefore, if Dr. Burns repairs a bunion deformity without surgically addressing the cause of the midfoot instability, he emphasizes the importance of continuing orthotic control to reduce the deforming force from acting again on the f
