Hallux valgus is a disease of an orthopedic nature that is more common in children and women. It is distinguished by the curvature of the axis of the foot, its middle part descends and thickens. In addition, a deformity of the thumb, a characteristic bump and muscle-ligament imbalance can be seen.
Other names of the disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue when walking, curvature of the axis of the leg.
Treatment is carried out by an orthopedic traumatologist.
Article for patients with a disease diagnosed by a doctor. It does not replace a doctor's prescription and cannot be used for self-diagnosis.
Reasons
Valgus deformation of the legs is almost always a complex formation. In most cases, there are combinations of the following prerequisites for this:
- Both congenital and acquired flat feet. As a result of its presence, weight and pressure are unevenly distributed, which causes deformation of the fingers.
- Osteoporosis characterized by loss of bone hardness and low calcium content.
- Obesity, overweight, which causes excessive stress on the bone, especially with muscle weakness.
- Hereditary tendency, when the ligaments are weak, as well as characteristic changes in the foot - hallux valgus - can be genetically predetermined.
- Wearing the wrong shoes. The problem often occurs in women due to walking in uncomfortable, narrow high-heeled shoes. In this case, the proper loading of the foot is disturbed and the probability of hallux valgus deformity increases.
- Injuries, such as a heavy object falling on the foot, fractures or bruises, can result in foot deformities.
- Accompanying 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 with any of these causes, 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 most attention is paid to the course of therapy.
Stages 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 larger it is, the more serious the degree of pathology. According to him:
- Stage I -15°;
- II - 20°;
- III - 30°;
- IV - more than 30°.
To fully assess the degree of hallux valgus deformity not only of the first toe, but also of the hind toe. There is a classification based on the installation of the heel relative to the axis of the calf:
- Stage I - the presence of straight legs, but a slight deviation up to 15 °;
- II - up to 23 °;
- III - up to 30 °;
- IV - the leg is completely straight, the deviation is more than 30 °, this is considered a severe form.
In general, depending on the severity of the condition and the degree of curvature, the following types of the nature of the course of the disease are distinguished:
- lung;
- average;
- heavy
According to their formation, foot deformities are divided into the following types:
- structure caused by congenital pathology;
- static, arising from the curvature of the spine;
- spasticity caused by excessive tension or muscle tone;
- traumatic foot deformation;
- 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 undergo examinations.
Symptoms
The special insidiousness of the pathology is that it does not manifest itself for a long time. Often, a person simply does not notice warning signs, including the formation of calluses in the same places, a feeling of rapid fatigue after a walk. Obvious problems begin only after the disease reaches a more serious stage, which makes treatment more difficult and longer.
Manifestations of hallux valgus can be varied and may include:
- fatigue when walking;
- corn;
- 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 bump, often called "finger bone";
- Deformation of the remaining toes that become hammertoes.
As the foot deformity progresses, the patient finds that the shoes they used to wear no longer fit. It becomes tight and uncomfortable as a result of increased tissue thickening, the appearance of new calluses and the addition of bursitis.
Finding shoes is difficult, sometimes almost impossible. In the advanced stages of hallux valgus, the pain constantly intensifies and 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 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 can occur. The most common are the following:
- Bursitis, that is, inflammation of the synovial bursa. This problem is expressed by swelling and pain in certain areas of the foot as a result of deformations of the foot joints.
- Arthritis is the destruction of cartilage, which leads to reduced joint mobility, pain and impaired walking.
- Due to the increased load, the knee joint wears out, the pressure on the spine increases and arthrosis occurs.
- Heel spur formation. In this case, a sharp, almost unbearable pain appears during 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.
Timely treatment is necessary to avoid negative consequences. The medical center employs experienced doctors who help patients with any form and degree of valgus.
Diagnostics
At the initial admission, the orthopedist-traumatologist conducts a complete examination and examination of the patient. For this, he visually evaluates the position, location, deviations of the legs and determines the presence of deformation of the front leg. However, this is not enough to draw a conclusion about the extent and nature of the problem, so further studies are ordered.
Instrumental methods
One of the main ways to evaluate hallux valgus is radiography in three projections. It allows not only to identify this problem, but also to identify a number of 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 determine the course of treatment for hallux valgus.
A more detailed study of hallux valgus deformation or, if necessary, additional studies are prescribed:
- If there is a suspicion of problems with local blood circulation, ultrasound can allow to identify disorders in the work of blood vessels.
- Computed tomography or magnetic resonance imaging will help exclude other pathologies similar to hallux valgus and obtain a more detailed picture of the disease.
- Plantography allows you to determine and determine the degree of flat feet.
- Podoscopy is a heel examination while standing.
There are no special laboratory research methods for the diagnosis of hallux valgus in adults and children. Usually, the listed examination methods are sufficient, but if necessary, the doctor may prescribe additional methods.
Hallux valgus is similar to other diseases, which makes differential diagnosis especially important. Among the most common:
- gout;
- osteoarthritis;
- arthritis.
The modern medical clinic has the latest diagnostic equipment. This allows us to quickly identify hallux valgus and conduct a complete examination and therapy.
Treatment of hallux valgus
Today, specialists have a number of methods to help patients with foot deformities. Even the first stage of therapy can vary depending on the specifics of a particular 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 methods that help to avoid surgical treatment, especially in the initial stages of the development of the pathology. 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, bolsters and other devices can be used to remove excess load from the metatarsal bone. It is important to understand that such treatment for hallux valgus is usually long-term and lasts more than six months, sometimes even more than a year.
- Physical therapy classes. An exercise therapy instructor selects a program for a particular patient and also teaches the correct technique for performing the exercises. It is important to consult a specialist at the first stage.
- Foot massage. It should be done only in specialized medical centers, because it is not aimed at relaxation, but at treating valgus.
- Taking non-steroidal anti-inflammatory drugs to both reduce the inflammatory process and relieve pain. It is important to consult a doctor before using such drugs.
- Proper nutrition, calcium-enriched diet.
In addition, the use of physiotherapeutic procedures is useful in the treatment of hallux valgus, which include:
- phonophoresis;
- UHF;
- magnetotherapy.
During the treatment of hallux valgus, it is recommended to avoid standing for a long time and focus your efforts on strengthening muscles and ligaments.
All of these methods can be used together or separately to treat hallux valgus. The course is prepared by the doctor depending on the situation and complexity of the specific case. However, they are more suitable 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 at a late stage, surgery is performed. This has its advantages, because the problem is solved at one stage, with non-surgical treatment of deformations of different parts of the foot, it often takes several years.
Today, doctors perform appropriate manipulations of many varieties. It depends on what type of procedure is right for a particular patient. According to this criterion, operations to correct hallux valgus are divided into the following:
- In 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 belong only to the I stage of the disease.
- A combination of effects on bone and soft tissue structures to treat foot deformities, such as the Schede operation.
- On the bones. This type of intervention is called osteotomy, which has many varieties. It is mostly used for moderate to severe foot deformities in adults.
Modern methods of surgical treatment of patients with foot deformities allow in many cases to perform the intervention percutaneously or using a laser, for example, resurfacing the "bone" for hallux abducto valgus. If it is possible to implement a minimally invasive type of therapy for hallux valgus deformities, the advantages are obvious:
- quick rehabilitation period;
- 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 position. However, the doctor takes into account the individual structure of the patient's feet, as they are unique.
Recovery after surgery to correct hallux valgus requires different time: from 2 weeks to 4 months, depending on the volume and complexity of the intervention. During the recovery period, it is necessary to wear special shoes, follow 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 at about one year of age when the child begins to walk. Sometimes a pediatrician sees a deviation and can show it and send it to an orthopedist for consultation.
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 legs, a valgus curvature occurs, massage, physiotherapy and physiotherapy are used. However, one of the main ways to correct the condition is to wear orthopedic shoes. As the child grows and the angle of the foot changes, it is selected individually;
Surgical treatment is used very rarely, and the question of its choice is always treated individually. They try not to use radical treatment with a small degree of damage.
The prognosis for the treatment of deformities of the first finger and valgus in general in children is often positive. If you follow all the doctor's recommendations and systematic observations, it is possible to completely restore the normal appearance and functionality of the foot.
Which doctor treats you?
Treatment of hallux valgus is traditionally carried out by an orthopedic traumatologist. It is this specialist who will help the patient when the first symptom of the disease is detected or for the purpose of prevention. In the case of pediatric illness, a specialist should have the skills and experience to manage such patients. If radical treatment of hallux valgus is necessary, the participation of a surgeon will be required.
Forecast
Hallux valgus deformity can be successfully eliminated with proper and timely therapy. 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, if you follow all the expert recommendations, it is also possible in case of early diagnosis. In severe cases, treatment of hallux valgus is also possible, but it will take longer and involves the use of more serious intervention methods. Especially in advanced cases, there is a risk that it will not be possible to completely restore the original position of the foot.
Prevention
There are no reliable ways to absolutely prevent hallux valgus. It is multifactorial in nature and often associated with 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 orthopedic traumatologist;
- timely detection and treatment of flat feet;
- wearing comfortable shoes except stiletto heels for women;
- use of orthopedic insoles if necessary;
- weight control, keeping it in a normal, optimal state;
- compliance with rest and work standards, especially when a person's professional activity is associated with increased stress on the legs;
- proper and balanced diet, rejection of bad habits;
- moderate level of physical activity implies both physical inactivity and the absence of excessive stress on the legs.
In a modern medical center, you can undergo modern diagnostics and treatment at any stage of hallux valgus development.