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In the March/April 2014 edition of The Journal of Foot and Ankle Surgery, Volume 53, Number 2, (www.JFAS.org), several podiatrists in Iowa published an articled called “Clarification of the Anatomic Definition of the Bunion Deformity.” Most patients encounter only the word “bunion” when they see their podiatrist. Most think that bunion is a bony bump on the side of the big toe joint. In fact, a bunion deformity is much more than just a painful bump. The podiatrist needs to understand precisely what kind of deformity you have resulting in the bony bump and therefore which parts of the foot need surgical correction. Although your podiatrist will likely never discuss with you the technical details of your deformity, she must know these details in order to determine what kind of surgery you might need. To give you an idea as to how complicated this can be, the authors conclude that the proper technical definition of a bunion deformity which they believe should be used is “hallux abducto valgus with metatarsus primus adducto valgus.” One of the interesting points made by these authors is that by realigning the sesamoid apparatus (2 little bones under your big toe joint) under a rotated first metatarsal without correcting that rotation can lead to your bunion coming back. Podiatrists operating on bunion deformities need to thoroughly understand your anatomy before operating and be aware of which bones and soft tissues need to be altered to restore your foot to a more normal condition. A podiatrist who you see for the first time who merely glances at the x-rays and then tells you that you should have surgery right away is probably not spending enough studying your deformity and is rushing to operate. If you feel this has happened to you, and you wound up with a poor outcome, you should contact me for an opinion as to your legal rights.