Hallux valgus is a common foot condition characterized by the deviation of the big toe (hallux) towards the second toe, resulting in a bony bump on the side of the foot. This condition is also known as a bunion. Here’s an overview of the presentation, diagnosis, and treatment of hallux valgus:
Symptoms
- Pain, swelling, and redness around the bony bump on the side of the foot
- Limited range of motion in the big toe
- Corns or calluses may develop on the affected foot
- Discomfort or pain while walking or wearing shoes
Risk factors
- Genetics – hallux valgus can run in families
- Footwear – shoes with narrow toe boxes and high heels can increase the risk of hallux valgus
- Gender – women are more likely to develop hallux valgus than men
- Age – the risk of developing hallux valgus increases with age
Workup
- Physical exam – the healthcare provider will evaluate the foot for the presence of a bony bump, redness, swelling, and limited range of motion in the big toe.
- X-rays – may be ordered to assess the severity of the deformity and determine the best treatment option.
Conservative treatment
- Wearing shoes with a wider toe box and lower heel can reduce pressure on the bunion and relieve symptoms.
- Using bunion pads or orthotics can also provide cushioning and support to the affected foot.
- Over-the-counter pain medications can be taken to alleviate pain and inflammation.
Surgical intervention
- If conservative treatments are not effective in relieving symptoms, surgery may be recommended.
- The goal of surgery is to correct the position of the big toe, remove the bony bump, and improve foot function.
- There are different surgical techniques available, and the choice of surgery depends on the severity of the deformity and the patient’s individual needs.
Overall, hallux valgus is a common foot condition that can be effectively managed with conservative treatments or surgery, depending on the severity of the deformity and the patient’s individual needs. It’s important to seek medical advice if you are experiencing foot pain or other symptoms.
Surgical intervention is often recommended for moderate to severe cases of hallux valgus, where conservative treatments have failed to provide adequate relief. The goal of surgery is to correct the position of the big toe, remove the bony bump, and improve foot function. There are several surgical techniques available, and the choice of surgery depends on the severity of the deformity and the patient’s individual needs. The most common surgical techniques are as follows:
- Osteotomy: In this procedure, the surgeon makes a cut in the bone of the big toe to realign it. This may involve removing a small piece of bone to correct the deformity. Osteotomy is often combined with soft tissue procedures, such as tendon or ligament repair or reconstruction, to further stabilize the toe joint.
- Arthrodesis: This procedure involves fusing the joint between the big toe and the foot. This can be done with screws or plates and is often recommended for severe cases of hallux valgus where the joint is severely damaged.
- Exostectomy: In this procedure, the surgeon removes the bony bump on the side of the foot. This can provide immediate relief of symptoms, but it does not correct the underlying deformity.
- Resection arthroplasty: This procedure involves removing a portion of the bone in the joint to reduce the size of the bony bump. This is often recommended for elderly patients or those with limited mobility.
- Lapidus procedure: This is a more involved surgery that involves fusing the first metatarsal bone to the midfoot bone to stabilize the joint and correct the deformity.
After surgery, patients will need to wear a surgical shoe or cast for a few weeks to allow the foot to heal. Physical therapy may be recommended to help restore strength and flexibility in the foot. It is important to follow postoperative instructions carefully to ensure a successful recovery.
In summary, surgical management of hallux valgus can provide significant relief of symptoms and improve foot function. The choice of surgery depends on the severity of the deformity and the patient’s individual needs, and it is important to discuss the risks and benefits of each procedure with a qualified healthcare provider.
