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 its middle part descends and thickens. In addition, a deformity in the big toe, a characteristic protuberance and muscle-ligamentous balance may appear.
Other names for the disease: hallux valgus, hallux valgus.
Main symptoms: pain, tiredness when walking, curvature of the foot axis.
Treatment is carried out by an orthopedist-traumatologist.
An article for patients with a disease diagnosed by a doctor. It does not replace a medical consultation 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, congenital and acquired. As a result of their presence, weight and pressure are unevenly distributed, which leads to deformation of the toes.
- Osteoporosis, characterized by loss of bone rigidity and low calcium content.
- Obesity, excess weight, which causes excessive stress on the bones, especially with muscle weakness.
- The hereditary predisposition, when the ligaments are weak, as well as the characteristic changes in the foot - hallux valgus - can be genetically predetermined.
- Wearing the wrong shoes. The problem usually occurs in women due to wearing narrow and uncomfortable high-heeled shoes. In this case, the correct load on the foot is disturbed and the likelihood of hallux valgus deformity increases.
- Injuries, for example, falling a heavy object on the leg, fracture or bruising 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 the course of therapy.
Internships and forms
One of the main criteria for assessing the severity of foot deformity in children and adults is the angle of deviation of the big toe. The higher it is, the more serious the degree of the pathology. According to her:
- Stage I -15°;
- II - 20°;
- III - 30°;
- IV - more than 30°.
Thoroughly assess the degree of hallux valgus deformation of not only the first toe but also the rear toe. There is a classification based on the installation of the heel in relation to the shin axis:
- Stage I - presence of flat feet, but with a slight deviation of up to 15°;
- II - up to 23°;
- III - up to 30°;
- IV - the foot is completely flat, the deviation is greater 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 nature of the course of the disease are distinguished:
- lung;
- average;
- heavy.
Due to formation, foot deformities are divided into the following types:
- structural, caused by congenital pathology;
- static, caused by curvature of the spine;
- spastic, resulting from excessive exertion or muscle tone;
- traumatic foot deformity;
- rickety and others.
Thus, 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, it is necessary to consult a doctor and undergo tests.
Symptoms
The special insidiousness of the pathology lies in the fact that it does not manifest itself for a long time. Often people simply do not notice warning signs, including the formation of calluses in the same places, a quick feeling of tiredness after walking. Obvious problems only begin after the disease reaches a more serious stage, which complicates and prolongs treatment.
The manifestations of hallux valgus can vary and include the following:
- fatigue when walking;
- calluses;
- 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 protrusion, often called the "toe bone";
- deformation of the remaining fingers, which become hammer toes.
As the foot deformity progresses, the patient realizes that the shoes they previously wore no longer fit. It becomes narrow and uncomfortable as a result of increased tissue thickening, the appearance of new calluses and the appearance of bursitis.
Finding shoes becomes difficult, sometimes almost impossible. In the advanced stages of hallux valgus, the pain intensifies and constantly 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 about 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 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 in the foot joints.
- Osteoarthritis is the destruction of cartilage, which leads to decreased joint mobility, pain and gait disturbances.
- Increased load, due to wear on the knee joint, increases pressure on the spine and osteoarthritis occurs.
- Heel spur formation. In this case, a sharp, almost unbearable pain appears when walking.
- Aquilobursitis and other diseases.
Furthermore, hallux valgus always represents a serious aesthetic problem, which is especially noticeable when wearing open shoes. This causes great psychological discomfort to the person, which can negatively affect their 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.
Diagnosis
At the initial consultation, the orthopedist-traumatologist performs a complete 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 deformations in the forefoot. However, this is not enough to reach a final conclusion about the extent and nature of the problem, so additional studies are commissioned.
Instrumental methods
One of the main ways to evaluate hallux valgus is x-ray in three projections. It allows not only to identify this problem, but also to identify several others, including subluxations, dislocations and osteoarthritis. It is based on the results of this examination that it is possible to estimate the magnitude of the angle deviation, make calculations and correctly prescribe the treatment of hallux valgus.
For a more detailed study of hallux valgus deformation or, if necessary, additional studies are prescribed:
- Ultrasonography can identify disturbances in the functioning of blood vessels if problems with local circulation are suspected.
- 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 flat feet.
- Podoscopy is an examination of the sole of the foot while standing.
There are no specific laboratory research methods for diagnosing hallux valgus in adults and children. Typically, the listed examination methods are sufficient, but if necessary, the doctor may prescribe others.
Hallux valgus can resemble other diseases, making differential diagnosis especially important. Among the most common are:
- drop;
- osteoarthritis;
- arthritis.
The modern medical clinic has state-of-the-art diagnostic equipment. This allows you to quickly identify hallux valgus and perform a thorough examination and therapy.
Hallux valgus treatment
Today, experts have several methods to help patients with foot deformities. Even the first stage of therapy may vary depending on the characteristics of a specific 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 avoid surgical treatment, especially in the early stages of the development of the pathology. Among the most common are the following:
- Wearing orthopedic shoes. It must be rigidly fixed, with a stable, low heel and an extended toe. Additionally, special insoles, pads, and other devices can be used to remove excess load from the metatarsal bone. It is important to understand that this treatment for hallux valgus is usually long-term and lasts more than six months, sometimes up to a year.
- Physiotherapy classes. The physical therapy instructor selects a program for a specific patient and also teaches the correct technique for performing the exercises. It is important to consult a specialist in the first stage.
- Foot massage. It should only be done in specialized medical centers, as it is not aimed so much at relaxation as at treating valgus.
- Take non-steroidal anti-inflammatory drugs, both to reduce the inflammatory process and to relieve pain. It is important to consult a doctor before using these medications.
- Proper nutrition, calcium-enriched diet.
Additionally, it is useful to use physiotherapeutic procedures in the treatment of hallux valgus, which may include:
- phonophoresis;
- UHF;
- magnetotherapy.
During hallux valgus treatment, it is recommended to avoid standing for a long time and focus your efforts on strengthening the muscles and ligaments.
All of these hallux valgus treatment methods 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 best suited for treating patients with early-onset hallux valgus or early-stage hallux valgus.
Surgical methods
If conservative treatment of foot deformities is ineffective or if the problem is detected late, surgery is performed. It has its advantages, as the problem is resolved in a single step, whereas in 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:
- In soft tissues. In this case, the treatment of hallux valgus in children and adults in the initial 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 bony and soft tissue structures to treat foot deformities, for example, the Schede operation.
- In 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, the intervention to be carried out percutaneously or with a laser, for example, resurfacing of the "bone" of the hallux abducto valgus. If it is possible to perform 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 objective 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 one year of age, when the child begins to walk. Sometimes the pediatrician notices a deviation and can highlight it and refer you to 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 resolved without surgery.
If at a young age, when placing the feet, a valgus curvature forms, 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 must be replaced.
Surgical treatment is extremely rarely used, 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 treating deformities of the first toe and valgus in general in children is usually 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?
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 prevention purposes. In the case of illness in children, the specialist must have skills and experience in managing these patients. If radical treatment of hallux valgus is necessary, the involvement of a surgeon will be necessary.
Forecast
With adequate 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 in the early stages of problem development.
However, this is possible if you follow all the specialist's recommendations, as well as in case of early diagnosis. In serious situations, treatment of hallux valgus is also possible, but it will take longer and involve the use of more serious intervention methods. 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 definitively prevent hallux valgus. It is multifactorial in nature and often due to genetic predisposition. However, there are several 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;
- wear comfortable shoes, except stiletto heels for women;
- if necessary, use of orthopedic insoles;
- weight control, keeping it in a normal and ideal state;
- compliance with rest and work standards, especially if a person's professional activity is associated with increased stress on the legs;
- adequate and balanced nutrition, abandonment of bad habits;
- a 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 diagnostics and treatment of hallux valgus at any stage of its development.