Hallux valgus is a condition that occurs more often in children and women and is orthopedic in nature. It is characterized by the curvature of the axis of the foot as the middle part descends and thickens. In addition, a deformation of the big toe, a characteristic bump and the muscular-ligamentous balance can occur.
Other names for the disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue when walking, curvature of the axis of the foot.
Treatment is carried out by an orthopedist-traumatologist.
An article for patients with a doctor-diagnosed illness. Does not replace a visit to the doctor and cannot be used for self-diagnosis.
Causes
A valgus deformity of the feet almost always has a complex origin. In most cases, combinations of the following requirements apply:
- Flat feet, both congenital and acquired. Its presence causes weight and pressure to be distributed unevenly, resulting in deformation of the toes.
- Osteoporosis, which is characterized by loss of bone stiffness and low calcium levels.
- Obesity, overweight that causes excessive stress on the bones, especially with muscle weakness.
- A hereditary predisposition in which the ligaments are weak, as well as characteristic changes in the foot - the hallux valgus - can be genetically predetermined.
- Wearing the wrong shoes. The problem often occurs in women because they walk in uncomfortable, narrow shoes with high heels. In this case, the correct loading of the foot is disrupted and the likelihood of hallux valgus deformity increases.
- Injuries such as a heavy object falling on the leg, a fracture, or bruises can cause the foot to deform.
- Concomitant diseases of the endocrine system of a neurological nature.
- Strong hormonal fluctuations, including during menopause, during pregnancy and during the natural course of the menstrual cycle.
Hallux valgus can occur for any of these reasons or a combination of them. However, it is not always possible to objectively determine the exact basis for the development of a hallux valgus. In this case, great importance is placed on therapy.
Steps and shapes
One of the main criteria for assessing the severity of a 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:
- Level I -15°;
- II - 20°;
- III - 30°;
- IV – more than 30°.
To fully assess the degree of deformation of the hallux valgus of not only the first toe, but also the hind toe. There is a classification based on the position of the heel relative to the shin axis:
- Stage I – the presence of flat feet, but with 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.
In general, depending on the severity of the situation and the degree of curvature, the following types of disease progression are distinguished:
- Lung;
- Average;
- difficult.
Based on their origin, foot deformities are divided into the following types:
- structural, which is caused by a congenital pathology;
- static, caused by curvature of the spine;
- spastic, resulting from overexertion or muscle tone;
- traumatic foot deformity;
- Rachitic and others.
Therefore, there are many types of deformities of the first toe and other parts of the foot. To determine the features of the course of the disease, a doctor's consultation and examination is necessary.
Symptoms
The special insidiousness of 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 and a quick feeling of fatigue after walking. Obvious problems begin only when the disease reaches a more serious stage, which complicates and prolongs treatment.
The manifestations of a hallux valgus can vary and include:
- tiredness when walking;
- corns;
- calluses that appear regularly and 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, often referred to as a "toe bone";
- Deformation of the remaining toes, which become hammertoes.
As the foot deformity progresses, the patient notices that the shoes they previously wore no longer fit. Due to the increasing thickening of the tissue, the appearance of new calluses and the development of bursitis, it becomes narrow and uncomfortable.
Finding shoes becomes difficult, sometimes almost impossible. In advanced stages of hallux valgus, the pain constantly intensifies, increases, discomfort is noted in the knee and hip joints, and the load on the spine increases. In the first stage of hallux valgus and other parts of the foot, the patient is usually only concerned with a cosmetic problem.
Complications
One of the terrible consequences of a 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 can occur. The most common are the following:
- Bursitis, namely inflammation of the bursa. This problem is manifested by swelling and pain in certain areas of the foot due to deformation of the ankle joints.
- Osteoarthritis is the destruction of cartilage, which leads to reduced joint mobility, pain and gait problems.
- Increased stress, which causes wear and tear on the knee joint, increases pressure on the spine and leads to osteoarthritis.
- Formation of a heel spur. In this case, a sharp, almost unbearable pain occurs when walking.
- Achilobursitis and other diseases.
In addition, hallux valgus always represents a serious aesthetic problem that is particularly noticeable when wearing open shoes. This causes a person great psychological discomfort, which can negatively affect his general psycho-emotional state.
To avoid negative consequences, timely treatment is necessary. The medical center employs experienced doctors who help patients with any form and degree of valgus.
diagnosis
At the first appointment, the orthopedist-traumatologist conducts a complete examination and examination of the patient. To do this, he visually assesses the condition of the feet, their position, deviations and determines the presence of a deformation of the forefoot. However, this is not enough to make a definitive statement about the extent and nature of the problem, so additional studies are being commissioned.
Instrumental methods
One of the most important methods for assessing hallux valgus is an X-ray in three projections. It allows not only the identification of this problem, but also the identification of a number of others, including subluxations, dislocations and osteoarthritis. Based on the results of this examination, it is possible to estimate the extent of angular deviation, make calculations and correctly prescribe treatment for hallux valgus.
For a more detailed examination of the hallux valgus deformity or, if necessary, additional examinations are prescribed:
- If local circulatory disorders are suspected, ultrasound can be used to detect disorders in the function of blood vessels.
- Computed tomography or magnetic resonance imaging helps to rule out other pathologies similar to hallux valgus and obtain a more detailed picture of the disease.
- Plantography, which allows you to detect and determine the degree of flatfoot.
- Podoscopy is an examination of the sole of the foot while standing.
There are no specific laboratory examination methods to diagnose hallux valgus in adults and children. As a rule, the listed examination methods are sufficient, but if necessary, the doctor can prescribe others.
Hallux valgus can resemble other diseases, which is why the differential diagnosis is particularly important. The most common include:
- Gout;
- osteoarthritis;
- Arthritis.
The modern medical clinic has the latest diagnostic equipment. This allows you to quickly identify hallux valgus and carry out a comprehensive 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 can vary depending on the specifics of the individual 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 options and techniques that help avoid surgical treatment, especially in the initial stages of the development of pathology. The most common include:
- Wearing orthopedic shoes. It should be firmly attached, with a stable and low heel and an extended toe. In addition, special insoles, bolsters and other aids can be used to relieve the metatarsal bone. It is important to understand that such treatment of hallux valgus is usually long-term and lasts more than six months, sometimes even a year.
- Physiotherapy courses. The exercise therapy teacher selects a program for a particular patient, and also teaches the correct technique for performing the exercises. It is important to consult a specialist as a first step.
- Foot massage. It should only be carried out in specialized medical centers, as it is aimed not so much at relaxation but at treating valgus.
- Taking non-steroidal anti-inflammatory drugs to both reduce the inflammatory process and relieve pain. It is important to consult a doctor before taking such medications.
- Proper nutrition, calcium-fortified diet.
In addition, the use of physiotherapeutic procedures is useful in the treatment of hallux valgus, which can include:
- phonophoresis;
- UHF;
- Magnetic field therapy.
When treating hallux valgus, it is recommended to avoid prolonged standing on your feet and to concentrate on strengthening the muscles and ligaments.
All of these methods of treating hallux valgus can be used in combination or individually. The course is designed by the doctor depending on the situation and complexity of each case. However, they are more suitable for treating patients with early-onset hallux valgus or early-stage hallux valgus.
Surgical methods
If conservative treatment of foot deformity is ineffective or the problem is detected at a late stage, surgery is performed. This has its advantages, as the problem is solved in one step, whereas non-surgical treatment of deformities of various parts of the foot often takes several years.
Nowadays, doctors carry out corresponding manipulations, which have many variations. It depends on what type of procedure is relevant for a particular patient. According to this criterion, operations to correct hallux valgus are divided as follows:
- On soft tissues. In this case, the treatment of hallux valgus in children and adults in the early stages of the development of the pathology can be the use of the Silver and McBride technique. They are only relevant for stage I of the disease.
- A combination of effects on bone and soft tissue structures for the treatment of foot deformities, for example the Schede operation.
- On the bones. This type of procedure is called an osteotomy and has many variations. It is most commonly used for moderate to severe foot deformities in adults.
Modern methods of surgical treatment of patients with foot deformities enable in many cases an intervention percutaneously or with a laser, for example the resurfacing of the "bone" in hallux abducto valgus. If it is possible to carry out a minimally invasive form of therapy for hallux valgus deformities, lying downthe advantages are obvious:
- quick rehabilitation times;
- absence of large incisions and seams;
- Elimination of the need for long-term hospitalization;
- low risk of complications.
The goal of any type of procedure is to return the foot 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 a different amount of time: from 2 weeks to 4 months, depending on the extent of the procedure and its complexity. During the recovery period, you must wear special shoes, follow the doctor's recommendations and take medications.
Features of treatment in children
Parents are often the first to notice hallux valgus in children. If it occurs 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, the problem can in most cases be solved without surgery.
If valgus curvature forms when the feet are planted at a young age, massage, physiotherapy and physiotherapy 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 needs to be replaced.
Surgical treatment is used extremely rarely and the question of its choice is always approached individually. If the degree of damage is small, they try not to use radical treatment.
The prognosis for treatment of first toe misalignment and valgus in general in children is often positive. If you follow all the doctor's recommendations and observe systematically, it is possible to completely restore the normal appearance and functionality of the foot.
Which doctor is treating you?
Treatment of hallux valgus is traditionally carried out by an orthopedist-traumatologist. It is this specialist who helps the patient when the first symptoms of the disease are noticed or for prevention. When it comes to children's illnesses, the specialist must have the skills and experience in caring for these patients. If radical treatment of hallux valgus is necessary, the cooperation of a surgeon is 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. The therapy is particularly successful with young children and at an early stage of problem development.
However, this is doable if you follow all the specialist's recommendations and make an early diagnosis. In severe situations, treatment of hallux valgus is also possible, but this takes longer and requires the use of more serious intervention methods. In particularly advanced cases, there is a risk that the original condition of the foot cannot be completely restored.
prevention
There are no reliable ways to definitely prevent hallux valgus. It is multifactorial in nature and often due to a genetic predisposition. However, there are a number of ways to reduce the risk of their occurrence or eliminate it at an early stage of development:
- regular preventive examinations by an orthopedist-traumatologist;
- timely detection and treatment of flat feet;
- Wearing comfortable shoes, excluding stilettos for women;
- if necessary, use of orthopedic insoles;
- Weight control, maintaining a normal, optimal condition;
- Compliance with rest and work standards, especially if a person's professional activity is associated with increased loads on the legs;
- proper and balanced nutrition, give up bad habits;
- a moderate level of physical activity, which means the absence of 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.