BUNION (It. bignonc, knob, OF. biotic, swelling, from Icel. bongo, elevation). A term applied in surgery to an enlarged bursa, or syno vial sae, situated over the metatarsal joint of the first or the fifth toe (see FOOT). and accompanied by more or less distortion of the joint. In the great majority of eases bunions are directly pro duced by the pressure of badly fitting boots; and if the boots are of patent leather, or any mate rial which stops the excreting action of the skin, this, too. may be regarded as an indirect cause of their formation. A bunion begins as a pain ful and tender spot over one of the metatarso phalangeal joints; the part gradually enlarges, and there are indications of an effusion into a natural bursa or a newly formed sac. The progress of the affection may stop here. the bursa remaining, and serving to protect the subjacent. parts from pressure; but far more frequently a corn develops on the summit of the bunion, or suppuration results, with great suffering. Thick
of the periosteum may result in enlarge ment of the articular ends of the bones and per manent deformity.
In its early stage the treatment must be palliative. Pressure must be removed and wet. dressings applied. If pus forms, the swelling must in incised. Ulceration must be treated as any similar wounds (q.v.), and internal sup portive and tonic treatment is necessary. Ex cision of diseased bone or even amputation may be required. The ulcers resulting from the burst ing of a bunion arc very ditlienit to hen] in old persons whose circulation is languid. Stimulat ing local application such as ointment of resin should be applied, while stimulants should bo prescribed for internal use, together with nour ishing diet. Such ulcers. under the best treat ment. not very infrequently form the starting point for senile gangrene.