Hallux valgus is a disease that is more common in children and women and is orthopedic in nature. It is distinguished by the curvature of the shaft of the foot, when its middle part descends and thickens. Additionally, bunion deformities, characteristic bunions, and musculo-ligamentous imbalance may be present.
Other names for the disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue when walking, curvature of the foot shaft.
Treatment is performed by an orthopedic-traumatologist.
An article for patients with diseases diagnosed by a doctor. Does not replace a doctor's appointment and cannot be used for self-diagnosis.
reason
Valgus deformities of the foot are almost always of a complex formation. In most cases, there is a combination of the following prerequisites for this:
- Flat feet, congenital and acquired. Due to its presence, weight and pressure are unevenly distributed, leading to deformation of the toes.
- Osteoporosis, which is characterized by loss of bone hardness and low calcium content.
- Obesity, being overweight, causes excessive stress on bones, especially muscle weakness.
- Hereditary predisposition to weak ligaments, as well as characteristic changes in the feet - hallux valgus - can be genetically predetermined.
- Wearing shoes incorrectly. The problem often occurs in women due to walking in narrow, uncomfortable high heels. In this case, the correct load on the foot is disrupted and the likelihood of hallux valgus deformity increases.
- Injuries, such as having a heavy object fall on your foot, broken bones or bruises can lead to foot deformities.
- Concomitant diseases of the endocrine system, nervous properties.
- Severe fluctuations in hormones, including during menopause, during pregnancy, as well as during the natural course of the menstrual cycle.
Hallux valgus can occur for any of these reasons, as well as a combination of them. However, it is not always possible to objectively determine the exact basis for the development of hallux valgus. In this case, the greatest emphasis is placed on the therapeutic process.
Stages and forms
One of the main criteria for assessing the severity of foot deformities in children and adults is the angle of deviation of the big toe. The older you get, the more serious the disease becomes. According to her:
- Phase I -15°;
- II - 20°;
- III - 30°;
- IV - more than 30°.
To fully assess the degree of deformity of hallux valgus not only of the big toe but also of the hind toe. There is a classification based on the installation of the heel relative to the axis of the shin:
- Stage I - presence of flat feet, but slightly misaligned up to 15°;
- II - up to 23°;
- III - up to 30°;
- IV - the foot becomes completely flat, the deviation is greater than 30°, considered a severe form.
In general, depending on the severity of the situation and the degree of curvature, the following types of properties of the disease process are distinguished:
- lung;
- medium;
- heavy.
Due to their formation, foot deformities are divided into the following types:
- structures caused by congenital diseases;
- static electricity due to curvature of the spine;
- spasticity due to excessive exertion or muscle tone;
- foot deformity due to trauma;
- rachitic et al.
Thus, there are many types of deformities in the big toe and other parts of the foot. To determine the characteristics of the course of the disease, it is necessary to consult a doctor and undergo an examination.
Symptom
The special insidiousness of the pathology lies in the fact that it does not manifest itself for a long time. Often, a person simply does not notice warning signs, including the formation of calluses in the same places, the feeling of rapid fatigue after walking. Obvious problems only begin after the disease has reached a more serious stage, making treatment more complicated and lengthy.
Manifestations of hallux valgus can vary and include the following:
- fatigue when walking;
- corn;
- Calluses appear frequently and continuously in the same place;
- pain;
- increased swelling in the lower extremities;
- deviation of the thumb to one side;
- the formation of a characteristic bump, commonly called a "toe bone";
- deformity of the remaining toes, becoming hammertoes.
As the foot deformity progresses, the patient notices that the shoes he previously wore no longer fit. It becomes narrow and uncomfortable as the tissue thickens, new calluses appear, and additional bursitis occurs.
Finding shoes becomes difficult, sometimes almost impossible. In severe stages of hallux valgus, pain constantly increases, discomfort in the knee and hip joints is noted, the load on the spine increases. In the early stages of crooked toes and other parts of the foot, patients often only care about aesthetic issues.
complications
One of the terrible consequences of lack of treatment is not only the progression of the pathology but also the increase of other related problems. With the development of hallux valgus, negative consequences may occur. The most common are the following:
- Bursitis, specifically bursitis. This problem is manifested by swelling and pain in certain areas of the foot due to deformity of the foot joints.
- Arthritis is the destruction of cartilage, leading to reduced joint mobility, pain and gait disturbances.
- The load increases, as the knee joint wears out, pressure on the spine increases and osteoarthritis occurs.
- Formation of heel spurs. In this case, a sharp, almost unbearable pain appears when walking.
- Achiloburitis and other diseases.
In addition, hallux valgus always causes serious cosmetic problems, especially noticeable when wearing open-toed shoes. This causes great psychological discomfort for a person, which can negatively affect his general psycho-emotional state.
To avoid negative consequences, timely treatment is required. The medical center employs experienced physicians to help patients with any form and degree of valgus.
Diagnose
At the first appointment, the orthopedic-traumatologist conducts a comprehensive examination and examination of the patient. To do this, he visually assesses the condition of the feet, their position, deviation and determines the presence of deformities in the forefoot. However, this is not enough to draw final conclusions about the extent and nature of the problem, so additional studies need to be conducted.
Instrumental method
One of the main ways to evaluate hallux valgus is with three-projection radiographs. It allows not only the identification of this problem but also the identification of a number of other problems, including subluxation, subluxation and subluxation. Based on the results of this examination, it is possible to estimate the degree of deviation of the angles, calculate and correctly prescribe the course of treatment of valgus hallux.
For more detailed study of hallux valgus deformity or, if necessary, additional studies are prescribed:
- Ultrasound can help identify disorders in the functioning of blood vessels if a local circulatory problem is suspected.
- Computed tomography or magnetic resonance imaging will help rule out other conditions similar to hallux valgus and get a more detailed picture of the disease.
- Plantography, which allows you to identify and determine the degree of flat feet.
- Footoscopy is the examination of the soles of the feet in a standing position.
There are no specific laboratory studies to diagnose hallux valgus in adults and children. Usually the listed examination methods are enough, but if necessary, the doctor may prescribe additional methods.
Hallux valgus can resemble other diseases, making differential diagnosis especially important. Among the most popular are:
- gout;
- osteoarthritis;
- arthritis.
The modern medical clinic features the latest diagnostic equipment. This allows you to quickly identify hallux valgus and carry out a full examination and treatment.
Hallux valgus treatment
Today, experts have many methods to help patients with foot deformities. Even the first stage of treatment can vary depending on the characteristics of each particular case. If the severity of the disease is already severe, valgus hallux in adults is sometimes immediately initiated with surgical intervention.
Conservative method
There are many ways and techniques that help avoid surgical treatment, especially in the early stages of the development of the pathology. Among the most popular are:
- Wear orthopedic shoes. It must be firmly fixed, have a low and stable heel, and an extended toe. In addition, special insoles, spacers and other devices can be used to remove excess load from the metatarsal bones. It is important to understand that the treatment of such hallux valgus is often long-term and lasts more than six months, sometimes even a year.
- Physical therapy classes. The exercise therapy instructor chooses a program for a specific patient and also teaches the correct technique for performing the exercises. It is important to consult a specialist at the first stage.
- Foot massage. It should be performed only in specialized medical centers, as it is not intended for relaxation but for the treatment of valgus.
- Use non-steroidal anti-inflammatory drugs, both to reduce inflammation and to reduce pain. It is important to consult your doctor before using such medications.
- Proper nutrition, calcium-rich diet.
Additionally, the use of physical therapy procedures in the treatment of hallux valgus is helpful, which may include:
- phonology;
- UHF;
- magnetic field therapy.
During treatment of bunions, you should avoid standing on your foot for long periods of time and focus your efforts on strengthening your muscles and ligaments.
All of these hallux valgus treatments can be used in combination or separately. The course is developed by the doctor depending on the situation and complexity of the particular case. However, they are more suitable for treating patients with early-onset bunions or early-stage bunions.
Surgical method
If conservative treatment of foot deformities is ineffective or if the problem is detected at a late stage, surgery will be performed. It has its advantages, since the problem is solved in one stage, while non-surgical treatment of deformities in different parts of the foot, which usually takes several years.
Today, doctors perform appropriate manipulations, which are of many types. It depends on what type of procedure will be appropriate for a particular patient. According to this criterion, hallux valgus correction operations are divided into the following parts:
- On soft tissues. In this case, the treatment of hallux valgus in children and adults in the early stages of pathology development can be using the Silver and McBride technique. They are only relevant to stage I of the disease.
- Combination of effects on bone and soft tissue structures to treat foot deformities, e. g. Schede surgery.
- On bones. This type of intervention is called an osteotomy, and there are many types. It is commonly used for moderate to severe foot deformities in adults.
In many cases, modern surgical treatments for patients with foot deformities allow for percutaneous or laser interventions, such as "bone" resurfacing for hallux abductovalgus. If a minimally invasive type of therapy can be performed for bunions, the advantages are obvious:
- fast recovery time;
- no large incisions and seams;
- eliminates the need for long-term hospitalization;
- low risk of complications.
The goal of any type of intervention is to bring the foot closer to its natural and normal state. However, the doctor takes into account the individual structure of the patient's leg, as it is unique.
Recovery after surgery to correct a bunion takes varying amounts of time: from 2 weeks to 4 months, depending on the extent of the intervention and its complexity. During recovery, you will need to wear special shoes, follow your doctor's recommendations, and take medications.
Characteristics of treatment in children
Parents are often the first to notice hallux valgus in children. If it appears early, it will become noticeable around one year of age, when the child begins to walk. Sometimes a pediatrician notices a misalignment and may point it out and refer you to an orthopedist for advice.
If you consult a doctor in time, the situation can be corrected with conservative methods of therapy. If the baby's arch is misaligned, in most cases the problem can be resolved without surgery.
If at an early age, when placing the foot, a valgus curvature forms, then apply massage, physiotherapy, physiotherapy. However, one of the main ways to overcome this condition is to wear orthopedic shoes. It is chosen individually; As the child grows and the angle of the foot changes, it must be replaced.
Surgical treatment is used extremely rarely, and the question of its choice is always approached individually. With a mild level of damage, they try not to apply radical treatment methods.
The prognosis for treating big toe deformities and hallux valgus in children is usually positive. If you follow all the doctor's recommendations and make systematic observations, you can completely restore the normal appearance and function of your feet.
Which doctor is treating you?
Treatment of hallux valgus is traditionally performed by an orthopedic traumatologist. It is this specialist who will help the patient if the first symptoms of the disease are noticed or for prevention purposes. In the case of a disease in children, the specialist must have the skills and experience to handle that patient. If radical treatment of hallux valgus is required, the involvement of a surgeon is required.
Forecast
With appropriate and timely treatment, hallux valgus deformity can be successfully eliminated. In most cases, it is possible to stop the pain and achieve the desired aesthetic effect. Therapy is especially successful in young children, as well as in the early stages of the development of the problem.
However, this is possible if you follow all the recommendations of a specialist, as well as in case of early diagnosis. In severe situations, it is also possible to treat hallux valgus, but it will take more time and involve the use of more serious intervention methods. There is a risk of not being able to completely restore the original condition of the foot in especially severe cases.
prevent
There is no reliable way to definitely prevent hallux valgus. It is multifactorial in nature and is often due to genetic factors. However, there are several ways to reduce the risk of its occurrence or eliminate it at the initial stages of development:
- Regular preventive examinations by an orthopedic traumatologist;
- timely detection and treatment of flat feet;
- wear comfortable shoes, not including high heels for women;
- if necessary, use orthopedic insoles;
- Control weight, maintain normal and optimal state;
- compliance with rest and work standards, especially if a person's occupational activity is associated with increased stress on the legs;
- Proper, balanced nutrition, giving up bad habits;
- moderate level of physical activity, which implies the absence of physical inactivity and excessive stress on the legs.
In a modern medical center you can undergo modern diagnosis and treatment of valgus at any stage of its development.