Hallux valgus is a disease that occurs more often in children and women and is orthopedic in nature. It is characterized by the curvature of the leg axis, when the middle part descends and thickens. In addition, the deformity of the big toe, a characteristic bump, and the balance of the muscle ligaments may appear.
Other names of the disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue while walking, curvature of the leg axis.
The treatment is carried out by an orthopedic traumatologist.
Article for people suffering from a disease diagnosed by a doctor. It is not a substitute for a doctor's prescription and cannot be used for self-diagnosis.
Reasons
Valgus deformity of the legs is almost always complex in nature. In most cases, this involves a combination of the following prerequisites:
- Flat feet, congenital and acquired. Due to its presence, weight and pressure are distributed unevenly, which leads to deformation of the toes.
- Osteoporosis characterized by decreased bone stiffness and low calcium levels.
- Obesity, excess weight, which causes excessive stress on the bones, especially with muscle weakness.
- The hereditary tendency, when the ligaments are weak, as well as the characteristic changes of the foot - hallux valgus - are genetically predetermined.
- Wearing the wrong shoes. The problem often occurs in women due to walking in uncomfortable narrow high-heeled shoes. In this case, proper loading of the foot is interrupted and the probability of hallux valgus deformity increases.
- Injuries such as a heavy object falling on the foot, a fracture or a bruise can cause the foot to become deformed.
- Concomitant diseases of the endocrine system, neurological in nature.
- Sharp fluctuations in hormones, including menopause, during pregnancy, and during the natural course of the menstrual cycle.
Hallux valgus can occur due to any of these reasons or a combination of them. However, it is not always possible to objectively determine the exact basis of the development of hallux valgus. In this case, the greatest emphasis is placed on the therapeutic course.
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 bends. The higher the number, the more severe the degree of pathology. According to the girl:
- Section I -15°;
- II - 20°;
- III - 30°;
- IV - more than 30°.
A complete assessment of the hallux valgus deformity of not only the first but also the hind toe. There is a classification based on the installation of the heel in relation to the axis of the leg:
- 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, 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 the course of the disease are distinguished:
- lungs;
- average;
- difficult.
Due to the formation, foot deformities can be divided into the following types:
- structural, caused by congenital pathology;
- static, caused by the curvature of the spine;
- spastic, as a result of 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 perform tests.
Symptoms
The special insidiousness of the pathology lies in the fact that it does not appear for a long time. Often, a person simply does not notice the warning signs, including the formation of calluses in the same places, a quick feeling of fatigue after walking. Obvious problems only appear when the disease enters a more serious stage, which makes treatment difficult and long.
Manifestations of hallux valgus can be varied and include:
- fatigue when walking;
- corns;
- calluses that appear regularly, permanently in the same places;
- pain;
- increased swelling of the lower limbs;
- deviation of the thumb to the side;
- the formation of a characteristic bump, 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 wore before no longer fit. As a result of increasing tissue thickening, the appearance of new calluses and the development of bursitis, it narrows and becomes uncomfortable.
Finding shoes becomes difficult, sometimes almost impossible. In the advanced stages of hallux valgus, the pain constantly gets worse and worse, discomfort occurs 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 lack of therapy is not only the progression of the pathology, but also other related problems. Negative consequences can occur with the development of hallux valgus. The most common are:
- Bursitis, namely inflammation of the synovial bursa. This problem is expressed by swelling and pain in certain areas of the foot as a result of the deformity of the foot joints.
- Arthrosis is damage to the cartilage, which leads to reduced joint mobility, pain and gait disturbances.
- Increased load, due to which the knee joint wears out, the pressure on the spine increases, and arthrosis occurs.
- Formation of heel spur. In this case, sharp, almost unbearable pain occurs while walking.
- Achilobursitis and other diseases.
In addition, hallux valgus is always a serious aesthetic problem, which is especially noticeable when we wear 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 must be treated in time. The medical center is staffed by experienced doctors who help patients with any form and degree of valgus disease.
Diagnostics
At the initial appointment, the orthopedic traumatologist performs a full examination and examination of the patient. To do this, he visually assesses the condition, location and deviations of the legs and determines the presence of deformation of the front part of the leg. However, this is not enough to draw a final conclusion about the extent and nature of the problem, so further investigations are ordered.
Instrumental methods
One of the main ways to evaluate hallux valgus is radiography in three projections. It allows you to identify not only this problem, but also many others, including subluxations, dislocations and arthrosis. Based on the results of this examination, it is possible to estimate the magnitude of the deviation of the angles, perform calculations and correctly prescribe the treatment of hallux valgus.
For a more detailed examination of the hallux valgus deformity, or if necessary, additional examinations are prescribed:
- Ultrasound may allow the identification of vascular dysfunctions if local circulation problems are suspected.
- Computed tomography or magnetic resonance imaging helps to rule out other pathologies similar to hallux valgus and to get a more detailed picture of the disease.
- Plantography, which allows the identification and measurement of flat feet.
- Podoscopy is the examination of the sole in a standing position.
There are no special laboratory research methods for diagnosing hallux valgus in adults and children. Generally, the listed test methods are sufficient, but if necessary, the doctor can also prescribe additional ones.
Hallux valgus can resemble other diseases, so differential diagnosis is particularly important. The most common include:
- gout;
- osteoarthritis;
- arthritis.
The modern medical clinic has the latest diagnostic equipment. This allows for quick identification of hallux valgus and a comprehensive examination and therapy.
Treatment of hallux valgus
Today, specialists use many methods to help patients with foot deformities. Even the first stage of therapy can vary depending on the characteristics of the given case. If the extent of the disease is already severe, hallux valgus in adults sometimes begins immediately with surgical intervention.
Conservative methods
Many methods and techniques help to avoid surgical treatment, especially in the initial stages of the development of the pathology. Some of the most common include:
- Wearing orthopedic shoes. It should be rigidly fixed, with a stable and low heel and an extended toe. In addition, special insoles, supports, and other devices can be used to remove unnecessary stress 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.
- Physiotherapy classes. The exercise therapy instructor selects a program for a specific patient and also teaches the technique of correct execution of the exercises. It is important to consult a specialist at the first stage.
- Foot massage. It should be done only in specialized medical centers, since it is not aimed 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 your doctor before using such drugs.
- Proper nutrition, calcium-enriched diet.
In addition, it is useful to use physiotherapy procedures in the treatment of hallux valgus, which may include:
- phonophoresis;
- UHF;
- magnetotherapy.
When treating hallux valgus, it is recommended to avoid standing for long periods of time and focus your efforts on strengthening the muscles and ligaments.
All of these methods can be used in combination or separately to treat hallux valgus. The course is designed by the doctor depending on the situation and complexity of the given case. However, they are more suitable for the treatment of 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, we perform surgery. This has its advantages, since the problem is solved in one stage, while it often takes several years to treat deformities of different parts of the foot without surgery.
Today, doctors perform appropriate manipulations, of which there are many types. It depends on what type of procedure will be relevant for a particular patient. According to this criterion, operations for the correction of hallux valgus can be divided into:
- 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 done using the Silver and McBride technique. They only apply to stage I of the disease.
- A combination of effects on bone and soft tissue structures for the treatment of foot deformities, such as Schede surgery.
- On the bones. This type of intervention is called an osteotomy, of which there are many types. It is most often used in adults with moderate or severe foot deformity.
In many cases, modern methods of surgical treatment of patients with foot deformities allow percutaneous or laser intervention, for example, painting the "bone" on the surface for hallux abducto valgus. If minimally invasive therapy for hallux valgus deformities is possible, the benefits are obvious:
- fast rehabilitation time;
- absence of large cuts and seams;
- eliminating the need for long-term hospitalization;
- the risk of complications is low.
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 unique structure of the patient's foot, since it is unique.
Recovery after hallux valgus correction surgery takes varying time: from 2 weeks to 4 months, depending on the extent and complexity of the intervention. During the recovery period, you must wear special shoes, follow the doctor's recommendations, and use medications.
Features of treatment of 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 starts to walk. Sometimes the pediatrician notices a deviation and shows you and sends you to an orthopedic consultation.
If you consult a doctor in time, the situation can be corrected with conservative therapeutic methods. If the baby's arch is in a valgus position, in most cases the problem can be solved without surgery.
If valgus curvature develops at an early age when putting the feet on, massage, physiotherapy and physical therapy are used. However, one of the main ways to improve the situation is to wear orthopedic shoes. As the child grows and the angle of the foot changes, it is selected individually and needs to be replaced.
Surgical treatment is used extremely rarely, and the question of choice is always approached individually. In case of minor damage, they try to use non-radical treatment.
The prognosis for treatment of first toe deformity and valgus in general in children is often positive. If you follow all the doctor's recommendations and systematic monitoring, it is possible to completely restore the normal appearance and functionality of the foot.
Which doctor treats you?
Hallux valgus is traditionally treated by an orthopedic traumatologist. This specialist helps the patient when the first symptoms of the disease are detected or for prevention. In the case of children, the specialist must have the necessary skills and experience in treating such patients. If radical treatment of hallux valgus is required, the intervention of a surgeon will be necessary.
Forecast
Hallux valgus deformity can be successfully eliminated with appropriate and timely treatment. In most cases, it is possible to eliminate the pain and achieve the desired cosmetic aesthetic effect. The therapy is particularly successful in young children and in the early stages of the problem.
However, this can be done if you follow all the recommendations of the specialist, as well as in case of early diagnosis. In severe situations, treatment of hallux valgus is also possible, but it takes longer and requires more serious intervention methods. There is a risk that, especially in advanced cases, it is not possible to completely restore the original condition of the foot.
Prevention
There are no reliable methods to prevent hallux valgus. It is multifactorial and often due to a genetic predisposition. However, there are several ways to reduce the risk of its occurrence or to eliminate it at an early stage of development:
- regular preventive examination by an orthopedic traumatologist;
- timely recognition and treatment of flat feet;
- wearing comfortable shoes, except women's stilettos;
- use of orthopedic insoles if necessary;
- weight control, keeping it in normal, optimal condition;
- compliance with rest and work norms, especially if a person's professional activity is associated with increased stress on the legs;
- proper and balanced nutrition, giving up bad habits;
- moderate level of physical activity, which means lack of physical inactivity and excessive use of the legs.
In a modern medical center, modern diagnosis and treatment of hallux valgus can be performed at any stage of development.