Hallux valgus is a disease that is more common among children and women and is orthopedic in nature. It is distinguished by the curvature of the axis of the foot, when the middle part of it descends and thickens. In addition, a deformity of the big toe, a characteristic bump, and the muscular-ligamentous balance may appear.
Other names for the disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue when walking, curvature of the axis of the foot.
The treatment is carried out by an orthopedist-traumatologist.
An article for patients with a doctor-diagnosed disease. Does not replace a doctor's appointment and cannot be used for self-diagnosis.
Causes
Valgus deformity of the feet almost always has a complex nature of formation. In most cases, there are combinations of the following prerequisites for this:
- Flat feet, both congenital and acquired. As a result of its presence, weight and pressure are unevenly distributed, which leads to deformation of the toes.
- Osteoporosis, which is characterized by loss of bone stiffness and low calcium content.
- Obesity, excess weight, which causes excessive stress on the bone, especially with muscle weakness.
- Hereditary predisposition, when the ligaments are weak, as well as characteristic changes in the foot - hallux valgus - can be genetically predetermined.
- Wearing the wrong shoes. The problem often occurs in women due to walking in uncomfortable, narrow high-heeled shoes. In this case, the correct load on the foot is disrupted and the likelihood of hallux valgus deformity increases.
- Injuries, for example, a heavy object falling on the leg, a fracture, or bruises can result in deformation of the foot.
- Concomitant diseases of the endocrine system, neurological nature.
- Sharp 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 a course of therapy.
Stages and forms
One of the main criteria for assessing the severity of foot deformity in children and adults is the angle at which the big toe deviates. The larger it is, the more serious the degree of pathology. According to her:
- Stage I -15°;
- II - 20°;
- III - 30°;
- IV - more than 30°.
To fully assess the degree of deformation of the hallux valgus not only of the first toe, but also of the hind toe. There is a classification that is based on the installation of the heel relative to the axis of the shin:
- Stage I - the presence of flat feet, but a slight deviation of up to 15°;
- II - up to 23°;
- III - up to 30°;
- IV - the foot becomes completely flat, the deviation is more than 30°, which is considered a severe form.
Generally, according to the severity of the situation and the degree of curvature, the following types of the nature of the course of the disease are distinguished:
- lung;
- average;
- heavy.
Due to the formation, foot deformities are divided into the following types:
- structural, which is caused by congenital pathology;
- static, caused by curvature of the spine;
- spastic, resulting from overexertion or muscle tone;
- traumatic foot deformity;
- rachitic and others.
Thus, there are many types of deformities of the first 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 examinations.
Symptoms
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, a quick feeling of fatigue after walking. Obvious problems begin only after the disease reaches a more serious stage, which complicates treatment and makes it longer.
Manifestations of hallux valgus can vary and include the following:
- fatigue while walking;
- corns;
- calluses that appear regularly, constantly in the same places;
- pain;
- increased swelling of the lower extremities;
- deviation of the thumb to the side;
- the formation of a characteristic bump, which is often called a "toe bone";
- deformation of the remaining toes, which become hammertoes.
As the foot deformity progresses, the patient notices that the shoes he previously wore no longer fit. It becomes narrow and uncomfortable as a result of increasing tissue thickening, the appearance of new calluses, and the addition of bursitis.
Finding shoes becomes difficult, sometimes almost impossible. In advanced stages of hallux valgus, the pain constantly intensifies, increases, discomfort in the knee and hip joints is noted, and the load on the spine increases. At the first stage of hallux valgus and other parts of the foot, the patient is usually only concerned about a cosmetic problem.
Complications
One of the terrible consequences of the lack of therapy is not only the progression of the pathology, but also the addition of other related problems. With the development of hallux valgus, negative consequences may occur. The most common are the following:
- Bursitis, namely inflammation of the synovial bursae. This problem is expressed by swelling and pain in certain areas of the foot as a result of deformities of the foot joints.
- Arthrosis is the destruction of cartilage, which leads to decreased joint mobility, pain, and gait disturbances.
- Increased load, due to which the knee joint wears out, pressure on the spine increases, and arthrosis occurs.
- Formation of a heel spur. In this case, a sharp, almost unbearable pain appears when walking.
- Achilobursitis and other diseases.
In addition, hallux valgus always poses a serious aesthetic problem, which is especially noticeable when wearing open shoes. This causes great psychological discomfort to a person, which can negatively affect his general psycho-emotional state.
To avoid negative consequences, it is necessary to undergo timely treatment. The medical center employs experienced doctors who help patients with any form and degree of valgus.
Diagnostics
At the initial appointment, the orthopedist-traumatologist conducts a full examination and examination of the patient. To do this, he visually assesses the condition of the feet, their location, deviations, and determines the presence of deformation of the forefoot. However, this is not enough to make a final conclusion about the extent and nature of the problem, so additional studies are ordered.
Instrumental methods
One of the main ways to assess hallux valgus is radiography in three projections. It allows not only to identify this problem, but also to identify a number of others, including subluxations, dislocations, and arthrosis. It is based on the results of this examination that it is possible to estimate the magnitude of the deviation of the angles, make calculations and correctly prescribe a course of treatment for hallux valgus.
For a more detailed study of hallux valgus deformation or, if necessary, additional studies are prescribed:
- Ultrasound may make it possible to identify disturbances in the functioning of blood vessels if there is a suspicion of problems with local circulation.
- Computed tomography or magnetic resonance imaging will help to exclude other pathologies similar to hallux valgus and obtain a more detailed picture of the disease.
- Plantography, which allows you to identify and determine the degree of flatfoot.
- Podoscopy is an examination of the sole in a standing position.
There are no specific laboratory research methods for diagnosing hallux valgus in adults and children. Usually the listed examination methods are sufficient, but if necessary, the doctor may prescribe additional ones.
Hallux valgus may resemble other diseases, making differential diagnosis especially important. Among the most common are:
- gout;
- osteoarthritis;
- arthritis.
The modern medical clinic has the latest diagnostic equipment. This allows you to quickly identify hallux valgus and conduct a full examination and therapy.
Treatment of hallux valgus
Today, specialists have a number of methods to help patients with foot deformities. Even the first stage of therapy may vary depending on the characteristics of a particular case. If the degree of the disease is already severe, hallux valgus in adults sometimes begins immediately with surgical intervention.
Conservative methods
There are many ways and techniques that help to avoid surgical treatment, especially in the initial stages of the development of pathology. Among the most common are the following:
- Wearing orthopedic shoes. It should be rigidly fixed, with a stable and low heel, and an extended toe. In addition, special insoles, bolsters and other devices can be used to remove excess load from the metatarsal bone. It is important to understand that such treatment for hallux valgus is usually long-term and lasts more than six months, sometimes even a year.
- Physical therapy classes. The exercise therapy instructor selects a program for a specific patient and also teaches the correct technique for performing the exercises. It is important to consult with a specialist at the first stage.
- Foot massage. It should be done only in specialized medical centers, since it is aimed not so much at relaxation, but at treating valgus.
- Taking non-steroidal anti-inflammatory drugs, both to reduce the inflammatory process and to relieve pain. It is important to consult a doctor before using such medications.
- Proper nutrition, diet enriched with calcium.
In addition, the use of physiotherapeutic procedures in the treatment of hallux valgus is useful, which may include:
- phonophoresis;
- UHF;
- magnetotherapy.
During the treatment of hallux valgus, it is recommended to avoid prolonged standing on your feet and to focus your efforts on strengthening the muscles and ligaments.
All of these methods for treating hallux valgus 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-stage hallux valgus or early stage hallux valgus.
Surgical methods
If conservative treatment of foot deformities is ineffective, or if the problem is detected at a late stage, surgery is performed. It has its advantages, since the problem is solved in one stage, whereas with non-surgical treatment of deformities of various parts of the foot, this often takes several years.
Today, doctors carry out appropriate manipulations, which have many varieties. It depends on what type of procedure will be relevant for a particular patient. According to this criterion, operations to correct hallux valgus are divided into the following:
- On soft tissues. In this case, the treatment of hallux valgus in children and adults in the early stages of the development of pathology can be the use of the Silver and McBride technique. They are relevant only for stage I of the disease.
- A combination of effects on bone and soft tissue structures to treat foot deformities, for example, Schede's operation.
- On the bones. This type of intervention is called osteotomy, which has many varieties. It is most often used for moderate to severe foot deformities in adults.
Modern methods of surgical treatment of patients with foot deformities allow, in many cases, intervention to be performed percutaneously or using a laser, for example, resurfacing the "bone" for hallux abducto valgus. If it is possible to carry out a minimally invasive type of therapy for hallux valgus deformities, the advantages are obvious:
- fast rehabilitation times;
- absence of large incisions and seams;
- eliminating 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 legs, as it is unique.
Recovery after surgery to correct hallux valgus takes varying times: from 2 weeks to 4 months, depending on the extent of the intervention and its complexity. During the recovery period, you will need to wear special shoes, follow the doctor's recommendations, and use medications.
Features of treatment in children
Parents are often the first to notice hallux valgus in children. If it appears early, it becomes noticeable around the age of one year, when the child begins to walk. Sometimes a pediatrician notices a deviation and can show it and refer you for a consultation with an orthopedist.
If you consult a doctor in a timely manner, the situation can be corrected using conservative methods of therapy. If the baby's arch is in a valgus position, in most cases the problem can be solved without surgery.
If at an early age, when placing the feet, a valgus curvature is formed, massage, physiotherapy, and physical therapy are used. However, one of the main ways to correct the situation is to wear orthopedic shoes. It is selected 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 small degree of damage, they try not to use radical treatment.
The prognosis for treatment of deformities of the first toe and valgus in general in children is often positive. If you follow all the doctor’s recommendations and systematic observation, it is possible to completely restore the normal appearance and functionality of the foot.
Which doctor is treating you?
The treatment of hallux valgus is traditionally carried out by an orthopedist-traumatologist. It is this specialist who will help the patient if the first symptom of the disease is noticed or for the purpose of prevention. In the case of illness in children, the specialist must have the skills and experience in managing such patients. If radical treatment of hallux valgus is necessary, the participation of a surgeon will be required.
Forecast
With proper and timely therapy, hallux valgus deformity can be successfully eliminated. In most cases, it is possible to stop the pain and achieve the desired cosmetic aesthetic effect. Therapy is especially successful in young children, as well as at an early stage of the development of the problem.
However, this is doable if you follow all the specialist’s recommendations, as well as in case of early diagnosis. In severe situations, treatment of hallux valgus is also possible, but it will take longer and involve the use of more serious methods of intervention. There is a risk that it will not be possible to completely restore the original condition of the foot in particularly advanced cases.
Prevention
There are no reliable ways to definitely prevent hallux valgus. It is multifactorial in nature and is often due to genetic predisposition. However, there are a number of ways to reduce the risk of its occurrence or eliminate it at an early stage of development:
- regular preventive examination by an orthopedist-traumatologist;
- timely detection and treatment of flat feet;
- wearing comfortable shoes, excluding stiletto heels for women;
- if necessary, use of orthopedic insoles;
- weight control, maintaining it in a normal, optimal state;
- compliance with rest and work standards, especially if a person’s professional activity is associated with increased stress on the legs;
- proper and balanced nutrition, giving up bad habits;
- a moderate level of physical activity, which implies the absence of both physical inactivity and excessive stress on the legs.
In a modern medical center you can undergo modern diagnostics and treatment of hallux valgus at any stage of its development.