Hallux valgus is a more common disease among children and women and is orthopedic in nature. It is distinguished by the curvature of the leg axis, when the middle part is lowered and thickened. In addition, deformities of the big toe, characteristic bumps, and muscle-ligament balance may appear.
Other names for this disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue when walking, curvature of the leg axis.
The treatment is carried out by an orthopedic-traumatologist.
Articles for patients with diseases diagnosed by doctors. Does not replace a doctor's appointment and should not be used for self-diagnosis.
Cause
Valgus deformity of the foot almost always has a complex nature of formation. In most cases, there is a combination 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 body weight, which causes excessive pressure on the bones, especially with muscle weakness.
- Hereditary tendencies, when the ligaments are weak, as well as a characteristic change in the foot - hallux valgus - can be determined genetically.
- Wearing the wrong shoes. This problem often occurs in women due to walking in uncomfortable and narrow high heels. In this case, the proper load on the foot is disturbed and the possibility of hallux valgus deformity increases.
- Injuries, for example, heavy objects falling on the foot, broken bones, or bruises can result in foot deformities.
- Concomitant diseases of the endocrine system, neurological nature.
- Sudden 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.
Stage and shape
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 larger it is, the more serious the level of pathology. According to him:
- Stage I -15°;
- II - 20°;
- III - 30°;
- IV - more than 30°.
To fully assess the degree of hallux valgus deformation not only on the first toe, but also on the rear foot. There is a classification 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 up to 15 °;
- II - up to 23°;
- III - up to 30 °;
- IV - the foot becomes completely flat, a deviation of more than 30 °, which is considered a severe form.
In general, according to the severity of the condition and degree of curvature, the following types of disease are distinguished:
- lungs;
- average;
- heavy.
According to the formation, foot deformities are divided into the following types:
- structure, caused by congenital pathology;
- static, due to the curvature of the spine;
- spasticity, resulting from too much energy or muscle tone;
- traumatic foot deformity;
- rachitic and others.
Therefore, there are many types of deformities in 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 an examination.
symptoms
The special peculiarity of the pathology lies in the fact that it does not manifest itself for a long time. Often a person does not notice the warning signs, including the formation of calluses in the same place, a quick feeling of fatigue after walking. Obvious problems begin only after the disease reaches a more serious stage, which complicates the treatment and makes it last longer.
Manifestations of hallux valgus can vary and include the following:
- fatigue when walking;
- corn;
- calluses that appear regularly, always in the same place;
- sick;
- increased swelling in the lower part;
- deviation of the thumb to the side;
- the formation of characteristic bumps, which are often called "leg bones";
- deform the remaining toes, which become hammertoes.
As the foot deformity progresses, the patient realizes that the shoes he was wearing before no longer fit. It becomes narrow and uncomfortable due to increased tissue thickening, the appearance of new calluses, and the addition of bursitis.
Finding shoes becomes difficult, sometimes almost impossible. In the advanced stages of hallux valgus, the pain constantly increases, increases, discomfort in the knee and hip joints is observed, and the load on the spine increases. In the first stage of hallux valgus and other parts of the foot, patients are usually only concerned about cosmetic problems.
Complications
One of the terrible consequences of the lack of therapy is not only the development of 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, which is inflammation of the synovial bursa. This problem is expressed by swelling and pain in a certain area of the foot due to the deformity of the foot joint.
- Arthrosis is the destruction of cartilage, which leads to decreased joint mobility, pain, and impaired walking.
- Increased load, which causes knee joints to wear out, pressure on the spine increases, and arthrosis occurs.
- Formation of heel spurs. In this case, a sharp, almost unbearable pain appears when walking.
- Achilobursitis and other diseases.
In addition, hallux valgus always creates 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. This medical center employs experienced doctors who help patients with any form and degree of valgus.
Diagnostics
At the initial appointment, the orthopedic-traumatologist conducts a full examination and examination of the patient. To do this, he visually assesses the condition of the legs, their location, deviations, and determines the presence of deformation of the front legs. However, this is not enough to draw final conclusions about the extent and nature of the problem, so additional studies are ordered.
Instrumental method
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 several others, including subluxations, dislocations, and arthrosis. Based on the results of this examination, it is possible to estimate the magnitude of the angular deviation, make calculations and correctly prescribe the course of treatment for hallux valgus.
For a more detailed study of hallux valgus deformation or, if necessary, additional studies are prescribed:
- Ultrasound may allow to identify disorders in the function 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 get a more detailed picture of this disease.
- Plantography, which allows you to identify and determine the level of flatfoot.
- Podoscopy is an examination of the soles of the feet while standing.
There is no specific laboratory research method to diagnose 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 very important. Among the most common are:
- gout;
- osteoarthritis;
- arthritis.
Modern medical clinics have the latest diagnostic equipment. This allows you to quickly identify hallux valgus and carry out a full 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 particular case. If the level of the disease is severe, hallux valgus in adults sometimes begins immediately with surgical intervention.
Conservative method
There are many ways and techniques that help to avoid surgical treatment, especially in the early stages of the development of the pathology. Among the most common are the following:
- Wear orthopedic shoes. It should be firmly 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 bones. 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 class. Exercise therapy instructors select programs for specific patients and also teach proper techniques for performing exercises. It is important to consult a specialist at the first stage.
- Foot massage. It should be done only in a specialized medical center, because it is not intended to relax, but to treat 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 the drug.
- Proper nutrition, calcium-enriched diet.
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 the muscles and ligaments.
All these methods to treat hallux valgus can be used in combination or separately. This course is developed by the doctor depending on the circumstances and complexity of the particular case. However, it is more suitable for treating patients with early hallux valgus or early stage hallux valgus.
Surgical method
If conservative treatment of leg deformities is ineffective, or if the problem is detected at a late stage, surgery is performed. It has its advantages, because the problem is solved in one stage, whereas with the non-surgical treatment of various leg deformities, this often takes several years.
Today, doctors carry out appropriate manipulations, which have many types. It depends on the type of procedure that will be relevant for a particular patient. According to these criteria, operations to correct hallux valgus are divided into the following:
- In soft tissue. 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 technique of Perak and McBride. They are only relevant for stage I of the disease.
- A combination of effects on bone and soft tissue structures to treat leg deformities, for example, the Schede operation.
- On the bone. This type of intervention is called osteotomy, which has many types. 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, interventions to be performed percutaneously or using a laser, for example, to regrow "bones" for hallux abducto valgus. If it is possible to carry out minimally invasive therapy for hallux valgus deformity, the advantages are clear:
- quick recovery time;
- the absence of large incisions and sutures;
- 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 a natural and normal state. However, the doctor takes into account the individual structure of the patient's foot, as it is unique.
Recovery after surgery to correct hallux valgus takes a varying amount of time: from 2 weeks to 4 months, depending on the level of intervention and its complexity. During the recovery period, you need to wear special shoes, according to the doctor's recommendations, and use medicines.
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, when the child begins to walk. Sometimes a pediatrician notices a deviation and can point it out and refer you to consult an orthopedist.
If you consult a doctor in time, the condition can be corrected using conservative therapy methods. 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, 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; when the child grows and the angle of the foot changes, it must be replaced.
Surgical treatment is used very 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 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 fully restore the normal appearance and function of the feet.
Which doctor treated you?
Treatment of hallux valgus is traditionally carried out by orthopedic-traumatologists. It is this specialist who will help the patient if the first symptoms of the disease are observed or for preventive purposes. In the case of diseases in children, specialists 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 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 the development of the problem.
However, this can be done if you follow all the recommendations of experts, as well as in the case of early diagnosis. In severe cases, hallux valgus treatment 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 fully restore the original condition of the foot in further cases.
Prevention
There is no reliable way to reliably prevent hallux valgus. It is multifactorial and often caused by genetic predisposition. However, there are several ways to reduce the risk of its occurrence or eliminate it in the early stages of development:
- regular preventive examination by an orthopedic-traumatologist;
- timely detection and treatment of flat feet;
- wear comfortable shoes, excluding stiletto heels for women;
- if necessary, use orthopedic insoles;
- control body weight, maintaining it in a normal, optimal state;
- compliance with rest and work standards, especially if a person's professional activity is associated with increased pressure on the legs;
- proper and balanced nutrition, abandoning bad habits;
- moderate level of physical activity, which implies the absence of both physical inactivity and excessive stress on the legs.
In modern medical centers you can undergo modern diagnostics and treatment of hallux valgus at any stage of its development.