Hallux valgus is a deviation of the tip of the big toe towards the lateral side, with the formation of a painful bony bump on the medial side of the foot at the joint between the metatarsal and the 1st phalanx. This bump becomes increasingly painful due to friction against the shoe and the joint’s discomfort.
The pain tends to spread to the other toes due to crowding and altered mechanical forces in the sole of the foot.
The big toe can no longer perform its function of propulsion during walking. As a result, these propulsive forces are distributed to the other toes.
In the vast majority of cases, the progression of the deformity is very slow. The normal position of the bones, tendons, and ligaments gradually changes over time.
As the big toe tilts towards the second toe, it can overlap it and cause additional issues. This can gradually lead to deformities of the lateral toes, such as hammer or claw toes.
Calluses can also develop where the toes rub against each other or against shoes, causing additional discomfort and difficulty in walking.
Hallux valgus is more common in women than in men, often with a family and genetic factor. This is particularly true for hallux valgus in adolescents, which develops early in life.
Most cases develop in adulthood and result from repetitive microtrauma, often associated with tight footwear around the toes.
Standing X-rays are often sufficient for diagnosis:
- Measure the alignment of the bones in the toes.
- Evaluate damage to the metatarsophalangeal joint. Long-standing hallux valgus can be accompanied by arthritic changes.
In general, non-painful hallux valgus deformities can be managed with non-surgical treatment.
A significant portion of mild deformities and discomfort can be successfully managed with proper shoe adjustments.
Your surgeon will provide you with information on proper shoe fit and the type of footwear that would suit you best.
Custom-made orthopedic insoles, protective silicone pads, and toe spacers worn inside your shoe can help cushion the painful area over the bunion.
The effectiveness of orthopedic insoles and small orthoses at this stage is variable, and very few high-quality scientific studies demonstrate their beneficial effects.
Common pain relievers and anti-inflammatories can also help alleviate mild and occasional pain. The consumption of large quantities of pain relievers often indicates the need for an alternative solution.
WEARING SHOES :
It will take several months for your bones to fully heal. When you have completed the initial rehabilitation period, your doctor will advise you on footwear. Athletic shoes or soft leather oxford-style shoes will provide the best protection for the bunion correction until the bones are completely healed.
To help prevent the recurrence of your bunion, avoid wearing fashionable shoes until your doctor permits it. Be aware that your doctor may recommend never wearing high-heeled shoes.
Because one of the primary causes of bunion deformity is ill-fitting footwear, returning to this type of shoe can lead to the return of your bunion. Always follow your doctor’s recommendations for proper shoe fit.
POSSIBLE COMPLICATIONS :
As with any surgical procedure, there are risks associated with bunion surgery. These rarely occur and are generally treatable, although in some cases, they may limit or prolong your full recovery.
Before your surgery, your doctor will discuss each of these risks with you and take specific measures to prevent complications.
The possible risks and complications of bunion surgery include:
- Stiffness of the big toe joint
- Recurrence of the bunion
- Nerve, tendon, or vascular injury
- Delayed bone healing