The most common cause of hallux valgus is poorly fitting shoes, according to the American Academy of Orthopaedic Surgeons. Shoes with a tight toe box that push the toes together can lead to the formation of a bunion. High-heeled shoes are the worst for this condition. In fact, the American Academy of Orthopaedic Surgeons state that studies have shown that the majority of women in the U.S. wear shoes that are too small, and over half of them have bunions. Other factors like improper foot mechanics due to altered arch height play a role. Hallux valgus can also result from genetic factors and conditions like arthritis and neurological disorders. Traumatic compromises are known as the key factors which produce the development of Hallux Valgus. In other words, Hallux Valgus also occurs after an accident which has expansion capsular rupture or the one that divided the articular capsule. It can also occur in post-traumatic disorders which lead to flat foot. Besides, it is found that the overuse of the extensor halucis tendons can lead to the development of Hallux Valgus. Such foot traumas as malunion fractures, intra-articular damages, soft-tissue sprains, complicated dislocations can lead to a rather painful form of this condition. (Carl et al., 1988 The study mentions other possible causes for failure such as the fact that the drill holes through the second metatarsal bone will naturally weaken the bone. In addition they mention the fact that the first metatarsal bone has its own range of motion independent from the other metatarsal bones, thus putting more stress on the second metatarsal bone. Exacerbating the problem is the fact that the tension wire itself is made of a hard abrasive suturing material that over time in connection with the movement of the first metatarsal will cause a "sawing" motion on the second metatarsal and will eventually weaken the bone. A bony bump on the outer big toe joint is known as bunion (hallux valgus). This is very painful and is caused due to hereditary factors, ill-fitting shoes, underlying medical conditions like arthritis or when there is too much stress put on the feet. Bunions cause the big toe to lean into the next toe instead of its normal straight position. Thus, the toes get misaligned and a bump is seen. When there is inflammation, it leads to a red, tender and painful toe. If you have bunions on your baby toe, it is known as bunionettes or tailor's bunions. Sometimes patient may complain of pain as well as deformity of the big toe (first digit) when they try to fit into their shoe. On inspection, the patient has an impaired gait with a wide forefoot and displacement of the big toe above may be above or below the second toe and lateral deviation of the other digits. The bunion may appear inflamed or ulcerated on the medial sides of the foot. The first metatarsal is eminence. Callus which is painful develop on the second toe. Skin keratoses present under the metatarsal head and the increase in the angle of the valgus at the first metatarsophalangeal joint. Most people can blame their bunions on heredity. In other words, you may have inherited a faulty foot bone structure that makes you more prone to bunions. Flat feet are also a culprit and younger patients may be diagnosed with bunions because of hyper-flexibility. While wearing shoes that are too tight, high heels that crowd the toes, and spending a lot of time on your feet won’t cause bunions, these situations can exacerbate the problem causing symptoms to appear faster and be more severe. For these reasons, women are treated for bunions more often than men are. A bunion (hallux valgus) is an enlargement of the bone or tissue around a joint at the base of the big toe or at the base of the little toe (in which case it is called a “bunionette” or “tailor’s bunion”). Bunions often occur when the joint is stressed over a prolonged period. Ninety percent of bunions occur in women, primarily because women may be more likely to wear tight, pointed, and confining shoes. Bunions may be inherited as a family trait. Bunions may also result from arthritis, which often affects the big toe joint. A 2-mm incision is made in the medial side of the great toe, approximately 5 mm plantar to the proximal edge of the nail (Figure 1). The wire entrance may be located dorsally when plantar metatarsal head displacement is desired, and plantarly if dorsal metatarsal head displacement is chosen. A second incision is made at the subcapital region of the first metatarsal, equidistant between the dorsal and plantar aspects of the bone (Figure 2). A 2-mm Kirschner wire is inserted retrograde from the first to the second incision (Figure 3). The K-wire must be placed subcutaneously and extraperiosteally to perform the metatarsal head displacement at the osteotomy site. Hallux Valgus is the result of overpronation over time. Pronation is when your foot unlocks or flattens as your heel hits the ground; it does this to absorb shock. When you arch fails to adequately support your bodyweight against gravity, you overpronate. This forces your big toe to deviate toward your baby toe; it’s a compensation to overpronation. For example, if you pick up something rather heavy with your right hand, your entire body will shift to the left to keep you from falling – this is a compensation. Your body has shifted left and that’s abnormal, but the cause is hanging from your right hand. There is no single cause of a bunion. It may develop from arthritic joint destruction, overpronation of the foot, heredity, or from ill-fitting tight shoes. It results in ugly misshapen feet with big toe angling in and either tucking under or over your second toe. It is usually painless but can be quite painful if allowed to progress. A bunion has the tendency to increase in size due to excessive weight load and from foot pressure. It causes widening of the forefoot and may in turn cause your gait to become off balance. A bunion on your small toe, though not as common is called a tailor's bunion.