Hallux Valgus – Prevention and our surgical methods

event 28.08.2017.

The term HALLUX VALGUS comes from Latin words that symbolize the turning of the big toe to the outside of the foot (toward the other toes).

As a result of the rotation, the inner part of the foot becomes more susceptible to constant mechanical irritation, which causes the formation of new bone (exostosis) and local inflammation, which is the main cause of pain in such a deformed foot.

Causes of occurrence

The most common cause of Hallux valgus deformity is the long-term wearing of inappropriate, usually tight footwear, which press the toes and put them in an irregular and unnatural position.

The deformity can also be caused by chronic inflammation (arthritis), either as a result of excessive wear of articular cartilage or due to an autoimmune disease, of which rheumatoid arthritis is the most common in the population. In most cases, there is also a positive family history.

AOFS research has shown that 88% of women in the US wear inappropriate footwear, and 55% of them develop a big toe deformity. Therefore, it is not surprising that the deformity of the big toe is nine times more common in women than in men.

Can inflammation be prevented?

The deformity soon becomes painful, and redness and soreness similar to gout appear on the inside of the foot. If the deformity is not identified in time and an attempt is made to treat it, soon the II and III toes of the foot are at risk – painful flexion of the small joints occurs, which is often the cause of greater problems than the big toe itself.

In most cases, inflammation and pain can be successfully prevented by wearing appropriate footwear that does not put pressure on the toes. With various orthoses on the market, we keep the thumb in the corrected position during the night; during the day, an adequate orthopedic insole can maintain such a position.

To whom is surgery recommended?

Many studies have shown that 85-95% of patients who underwent surgery were satisfied with the result of the surgery.

Reasons why you should opt for surgery:

  • pain that prevents you from carrying out daily activities, especially when walking or wearing shoes
  • chronic inflammation and swelling that does not stop with rest or medication
  • deformation of the fingers – turning the bigger fingers towards the smaller ones, raising the II and III fingers, etc.
  • stiffness of fingers – inability to bend and extend
  • constant pain that does not decrease even with the use of non-steroidal anti-inflammatory drugs (in general, the effect of such drugs varies from person to person)
  • the presence of pain even after wearing appropriate footwear.

Be careful when choosing a surgical procedure because names like “simple” and “minimal” surgery can often do more harm than good. The goal of the operation is to stop the pain and correct the deformity as much as possible.

Types of Surgery

An orthopedic surgeon chooses orthopedic surgery based on the type and cause of foot deformity.

Orthopedic surgery uses many different surgical procedures, which we apply with success at the Etela Department of Aksis Special Hospital:

  • surgery on soft tissues (tendons and ligaments)
  • removal of exostosis
  • osteotomy
  • arthrodesis
  • arthroplasty.

Expectations post-surgery

When you decide to have an operation, it is important to understand the realistic expectations of its results and to understand what can be done with the operation.

Most patients who undergo the procedure feel a significant reduction in pain after the operation, with a visible alignment of the thumb. After the operation, you will receive instructions on what kind of footwear to wear, so that the deformity of the thumb does not return.

The success of the surgery largely depends on how well you follow your surgeon’s instructions over the next few weeks. During the recovery phase, several follow-up examinations are necessary, during which your surgeon will monitor the normal healing process of the wound.

Exercises to strengthen the feet

After surgery, it is necessary to restore the full range of motion and strength in the foot muscles through physical therapy. The orthopedist will recommend using some props during exercise to improve mobility and gain strength in the ankle joint and finger joints.