脚的大拇趾凸起通常情况叫做大脚骨。如果脚大脚趾在宝宝的年龄就开始向外侧便偏移，脚拇趾关节处突出，这就叫做拇外翻 英文名称为hallux valgus。俗称大脚骨，大骨拐，苦骨等，因各地方言不同而有不同的称谓。由于大拇趾向外翻，凸起，第一跖骨逐渐内翻，导致第一跖骨头骨赘行程，大脚骨随着年龄的增长而越来越严重。大脚骨多因遗传导致，但也有部分（约20%）是由于后天穿鞋不当造成或者加剧。大脚骨发生女性远远高于男性，长期打赤脚、不穿鞋的人很少有发大脚骨。
hallux-valgus-大脚骨
大脚骨的治疗，主要取决于个人，其症状因每个人而异，有些大脚骨严重而疼痛轻微，有些反之。由于大脚骨的疼痛因拇囊炎和鞋子摩擦有关，其痛苦程度与鞋子大小以及鞋子类型密切相关。由于大脚骨和鞋子的问题，导致许多人一辈子不能穿自己喜欢的鞋子，而只能望漂亮鞋子兴叹，我们建议没有做大脚骨手术的朋友穿宽松舒适的球鞋或者布鞋，最好不要穿尖头、高跟皮鞋，以免加重疼痛和不适。
实际上，有两个方法来对付大脚骨，要么买适应大脚骨的鞋子；要么做大脚骨手术来适应漂亮的鞋子。
一旦大脚骨疼痛严重或者需要穿漂亮鞋子，我们建议手术治疗大脚骨，大脚骨手术方法多种多样，可以依据每个人具体情况而设计不同手术方式。往往一种单独的手术方式并不能解决大脚骨，我们需要查看每个人大脚骨第一跖骨和第二跖骨之间的夹角，即所谓的（即IMA跖骨间角度），以及HVA（即拇外翻角度）来确定手术方式。还需要考虑是否有拇囊炎、籽骨移位以及内侧关节囊紧张度检测。
角度是制定手术方法的重要参考因素，如果只是单纯去掉第一趾骨头的多余骨赘，其手术后复发的几率将非常的高。而通过第一跖骨头截骨矫正手术，则能够更加有效矫正畸形，防治复发。再将拇囊炎清除，籽骨移位校正，内侧关节囊松解等系列手术，则是有效大脚骨手术方法。
以下是一段关于拇外翻的译文，供参考：
HalluxValgusBunionDeformityThe big toe of the foot is called the hallux. If the big toe starts to deviate inward in the direction of the baby toe the condition is called hallux valgus.
As the big toe drifts over into valgus, a bump starts to develop on the inside of the big toe over the metatarsal bone. This bone prominence on the inner edge for the metatarsal is referred to as a bunion.Bunions are commonly hereditary but may also be caused or aggravated by shoe wear.
The condition is far more common in women than in men and rarely occurs in individuals who do not wear shoes. Once a bunion is present the deformity of hallux valgus worsens slowly over time.
The treatment of a bunion depends entirely on how uncomfortable it is. Since the pain from a bunion is always aggravated by shoe wear, the symptoms will often depend on the type and size of shoes worn. The perception of pain or discomfort that people experience however is quite varied. There are some individuals who have small bunions that are very uncomfortable. This limits their ability to wear shoes comfortably.
On the other hand, some individuals may have quite significant deformities that are annoying but do not limit their activities in anyway.Realistically, there are only two ways to treat a bunion. Either change the size and shape of the shoe or change the size and shape of the foot.Once a bunion gets to be irritating or painful and shoe wear is uncomfortable, surgery may be recommended.
There are many different surgical procedures that can be performed. The decision to perform one type of surgery or another is based upon the extent and magnitude of the bunion deformity, the presence of arthritis in the big toe joint, and the space between the first and second metatarsals, which is called the intermetatarsal angle.The angles shown here help us decide which bunion operation would be the best. This is the angle between the 1st and 2nd metatarsal.It is very rare that a bunion can be treated by simply shaving down the bump of the bone.
Invariably, the deformity will recur and both the bunion and the hallux valgus will return. Therefore, the shaving of the bunion, called an exostectomy, is performed in conjunction with a cut of the first metatarsal bone (which is called an osteotomy).
Depending on the severity of the deformity, this osteotomy can be done either at the end of the metatarsal (a distal osteotomy) or if the deformity is more severe, the osteotomy is performed at the base of the first metatarsal (a proximal osteotomy).
我们从2004年起开始专门做大脚骨手术，至今已有数千真实成功大脚骨手术案例的经验，如果你有关于大脚骨的相关问题，我们随时为你解答。
