Hallux valgus is a disease that is more common in children and women and is orthopedic in nature. It is characterized by the curvature of the foot axis, when the middle part descends and thickens. In addition, a toe deformity, a characteristic bunion, and musculo-ligament imbalance may occur.
Other names for the disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue when walking, curvature of the shaft of the foot.
The treatment is carried out by an orthopedist-traumatologist.
Article for patients with a medical diagnosis of the disease. It does not replace a doctor's examination and cannot be used for self-diagnosis.
Causes
Valgus deformation of the foot 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 its presence, weight and pressure are unevenly distributed, which leads to deformation of the fingers.
- Osteoporosis, characterized by loss of bone stiffness and low calcium content.
- Obesity, excess weight, which causes excessive stress on the bones, especially with muscle weakness.
- Hereditary predisposition, when the ligaments are weak, as well as characteristic changes in the foot - hallux valgus - can be genetically determined.
- Wearing the wrong shoes. The problem often occurs in women due to walking in uncomfortable, tight shoes with high heels. In this case, the correct load on the foot is disturbed and the probability of hallux valgus deformity increases.
- Injuries, for example, a heavy object falling on the leg, a fracture or a bruise, can lead to foot deformity.
- Accompanying diseases of the endocrine system, of a neurological nature.
- Sharp fluctuations of 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.
Phases and forms
One of the main criteria for assessing the severity of foot deformities in children and adults is the angle at which the big toe deviates. The higher it is, the more serious the degree of pathology. in her words:
- I degree -15°;
- II - 20°;
- III - 30°;
- IV - more than 30°.
Fully assess the degree of hallux valgus deformation not only of the first, but also of the back toe. There is a classification based on the installation of the heel in relation to the axis of the lower leg:
- Phase I - presence of flat feet, but slight deviation 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 speaking, 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:
- lungs;
- average;
- heavy.
Due to their formation, foot deformities are divided into the following types:
- structural, which is caused by congenital pathology;
- static, caused by curvature of the spine;
- spastic, the result of overexertion or muscle tone;
- traumatic foot deformity;
- rickets and others.
So there are many types of deformities of the first toe and other parts of the foot. In order 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 the warning signs, including the formation of blisters in the same places, a quick feeling of fatigue after walking. Obvious problems begin only after the disease has progressed to a more serious stage, which makes treatment more difficult and longer.
Manifestations of hallux valgus can vary and include the following:
- fatigue while walking;
- corns;
- blisters 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 "finger bone";
- deformation of the remaining fingers, which become hammertoes.
As the foot deformity progresses, the patient notices that the shoes he used to wear no longer fit him. It becomes narrow and uncomfortable as a result of increasing tissue thickening, the appearance of new blisters and the addition of bursitis.
Finding shoes becomes difficult, sometimes almost impossible. In the advanced stages of hallux valgus, the pain constantly intensifies, intensifies, discomfort is noticed 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 the absence 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 appear. The most common are the following:
- Bursitis, or inflammation of the synovial bursa. This problem is expressed by swelling and pain in certain parts of the foot as a consequence of the deformity of the foot joints.
- Arthrosis is the destruction of cartilage, which leads to reduced mobility of the joints, pain and disturbances in walking.
- Increased load, due to which the knee joint wears out, the pressure on the spine increases and arthrosis occurs.
- Formation of a heel spur. In this case, a sharp, almost unbearable pain occurs when walking.
- Achilles bursitis and other diseases.
In addition, hallux valgus always represents 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.
In order to avoid negative consequences, it is necessary to undergo timely treatment. The medical center is staffed by experienced doctors who help patients with any form and degree of valgus.
Diagnostics
During the first examination, the orthopedic 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 deformation of the forefoot. However, this is not enough to make a final conclusion about the scope and nature of the problem, so additional research is required.
Instrumental methods
One of the main ways to assess hallux valgus is radiography 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 arthrosis. Based on the results of this examination, it is possible to estimate the size of the deviation of the angles, make calculations and correctly prescribe the treatment of hallux valgus.
For a more detailed study of the hallux valgus deformity or, if necessary, additional studies are prescribed:
- Ultrasound can enable recognition of disorders in the work of blood vessels if there is a suspicion of problems with local circulation.
- Computed tomography or magnetic resonance imaging will help rule out other pathologies similar to hallux valgus and provide 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 soles of the feet in a standing position.
There are no specific laboratory research methods for diagnosing hallux valgus in adults and children. The listed examination methods are usually sufficient, but if necessary, the doctor may prescribe additional ones.
Hallux valgus can resemble other diseases, which is why differential diagnosis is 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 complete examination and therapy.
Treatment of hallux valgus
Today, experts have a number of methods to help patients with foot deformity. Even the first phase of therapy can vary depending on the characteristics of a particular case. If the degree of the disease is already serious, 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 pathology development. Among the most common are the following:
- Wearing orthopedic shoes. It should be firmly fixed, with a stable and low heel and an extended toe. In addition, special insoles, pads, and other devices can be used to remove excess load from 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.
- Physical therapy classes. An exercise therapy instructor selects a program for a specific patient and also teaches proper exercise technique. It is important to consult a specialist in the first stage.
- Foot massage. It should be done only in specialized medical centers, because it is aimed not so much at relaxation, but at the treatment of 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 drugs.
- 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 standing on your feet for a long time and focus your efforts on strengthening muscles and ligaments.
All these methods for the treatment of hallux valgus can be used in combination or separately. The course is developed by the doctor depending on the situation and complexity of the specific case. However, they are more suitable for treating patients with early 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. This has its advantages, because the problem is solved in one stage, while in the case of non-surgical treatment of deformities of different parts of the foot, it often takes several years.
Today, doctors carry out appropriate manipulations, which have many variants. It depends on what type of procedure will be relevant for a particular patient. According to this criterion, hallux valgus correction operations 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 the pathology can be the use of the Silver and McBride technique. They are relevant only for stage I disease.
- A combination of effects on bone and soft tissue structures for the treatment of foot deformities, for example, Schede's operation.
- On the bones. This type of intervention is called osteotomy, which has many variants. 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 a large number of cases to perform the intervention percutaneously or with a laser, for example, restoring the "bone" for hallux abducto valgus. If it is possible to carry out minimally invasive therapy for hallux valgus deformities, the advantages are obvious:
- fast rehabilitation time;
- absence of large cuts and stitches;
- 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, because it is unique.
Recovery after hallux valgus correction surgery lasts differently: from 2 weeks to 4 months, depending on the scope of the intervention and its complexity. During the recovery period, you will have to wear special footwear, follow the doctor's recommendations and use medicines.
Characteristics of treatment in children
Parents are often the first to notice hallux valgus in children. If it occurs early, it becomes visible around one year, when the child starts to walk. Sometimes a pediatrician notices a deviation and can point it out and refer you to an orthopedist.
If you consult a doctor in time, the situation can be corrected with 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 foot, a valgus curve 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 the treatment of deformity of the first finger 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 feet.
Which doctor treats 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 diseases in children, the specialist must have the skills and experience in managing such patients. If radical treatment of hallux valgus is required, the participation of a surgeon will be required.
Forecast
With proper and timely therapy, hallux valgus deformity can be successfully removed. In most cases, it is possible to stop the pain and achieve the desired cosmetic aesthetic effect. The therapy is especially successful in young children, as well as in the early stages of the development of the problem.
However, it is feasible if you follow all the recommendations of experts, as well as in the case of early diagnosis. In difficult situations, the treatment of hallux valgus is also possible, but it will take longer and involve the application of more serious intervention methods. There is a risk that in particularly advanced cases it will not be possible to completely restore the original condition of the foot.
Prevention
There are no reliable ways to definitively prevent hallux valgus. It is multifactorial in nature and is often caused by a 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, except heels for women;
- if necessary, use of orthopedic insoles;
- weight control, maintenance in normal, optimal condition;
- compliance with rest and work standards, especially if the person's professional activity is associated with increased stress on the legs;
- proper and balanced diet, giving up bad habits;
- 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 diagnosis and treatment of hallux valgus at any stage of its development.