Summer may be the season for flip-flops but not for Allison Ho who, like many other women in Hong Kong, suffers from foot disorders. Ho (not her real name) wears wide-boxed flat shoes all year round to conceal bunions, a condition that affects about 37 per cent of Chinese women in Hong Kong, according to research published in the in 2010.
"Hongkongers like to look good. I'd be treated differently if clients saw my feet, so I buy funky designer flat shoes to hide them," says Ho, a brand consultant.
A bunion ( ) is where the big toe is bent towards the midline of the foot such that it often overlaps with the second toe, explains Douglas Horne, a founding partner of Douglas Horne Podiatry. "Traditionally, it was thought that bunions are caused by ill-fitting footwear, but I have seen too many women in ridiculous footwear with no bunions, and women who have worn flip-flops almost exclusively for years with serious deformity.
"Bunions are caused by biomechanical instability in the foot and can be hereditary. Caught early enough, it can be corrected by exercise, correct footwear advice, splints and orthotics."
For severe bunions, Dr Kong Siu-wah, specialist in orthopaedics and traumatology at Matilda International Hospital on The Peak, recommends surgery to correct the deformity and rebalance the toe - an option that Ho is considering. Left untreated, bunions can cause "lesser toes deformity" resulting in pressure ulcers or deep and painful calluses known as "intractable plantar keratoses", also a commonly experienced foot disorder.
In a 2004 study published in the ogy, 60 per cent of 784 adults tested as part of the research had corns and calluses. These conditions were more common in women and were primarily due to ill-fitting shoes. Plantar keratoses, in particular, can be very painful and can affect walking. "Chronic keratotic lesion may ulcerate and become infected. In the worst case, osteomyelitis [bone infection] may result and if unable to control, amputation of foot or leg may be required," Kong warns.
The most common cause of non-traumatic lower limb amputation is diabetic foot ulcers, a condition that Alexandra Duff, podiatrist at PhysioMotion, treats on a regular basis. According to the journal in 1998, diabetes contributed to about 80 per cent of 120,000 non-traumatic amputations performed yearly in the United States. In 2006, Britain's National Diabetes Support Team advised that more than one in 10 foot ulcers resulted in the amputation of a foot or a leg.
