WHAT IS A BUNION OR HALLUX VALGUS?
Hallux valgus is the deviation of the big toe outward, due to the misalignment of the bone structure that occurs in the toes.
The deformity consists of the big toe deviating outward and can end up being placed under or over the second toe, causing deformities of the latter.
This deviation of the big toe, over time and depending on the type of shoe worn, causes irritation on the inner part of the toe, progressively developing the characteristic protrusion known as a bunion.
The initial pain is caused by the pressure of the bunion or hallux valgus against the shoe, especially narrow ones, but over time the joint deformity causes pain.
WHAT IS THE CAUSE OF A BUNION OR HALLUX VALGUS?
Bunions or hallux valgus appear much more frequently in women than in men, although in theory, it is equally common. They originate and progress mainly due to two causes:
- One cause is the structure of the person's toes and foot, such as longer toes, flat feet, a short Achilles tendon, or certain joint laxity. Many of these characteristics are inherited, which explains why many people with bunions also have family members with the same problem.
- The footwear that is commonly worn, especially tight shoes with heels and narrow points, contributes to the development of bunions. Shoes are related to the development of the deformity but not as the sole cause.
WHAT IS THE CONSEQUENCE OF A BUNION OR HALLUX VALGUS?
- The big toe is fundamental for correct walking; if it does not function well, it causes difficulty in walking and pain in other areas due to overload.
- The misalignment of the big toe causes compression on the other toes, which can deviate or lift, causing claw or hammer toes.
SURGICAL TREATMENT.
The initial treatment for Hallux Valgus is conservative through footwear modification, meaning using wider, deeper, and more flexible shoes to avoid foot compression. Sometimes insoles or toe protectors can be used, but the use of correctors has not been proven effective.
Ultimately, surgery is performed on those bunions that do not respond to conservative treatment and thus reduce the quality of life. Consideration is given to work, recreational, or sports limitations, as well as difficulty with footwear or the need for analgesics.
The purpose of the surgical intervention is to realign the first ray and thus correct the different components of its deformity. Occasionally, some procedures are also performed on the adjacent toes or the metatarsals.
There are more than a hundred techniques described throughout history. However, currently, the most common are the following. During the surgical correction of your forefoot, we will perform one or more of the following procedures. The choice of procedure will depend on factors such as age, the condition of the bone and joints, the degree of toe deviation, and the angles formed by the metatarsals with each other and with the phalanx.
FIRST METATARSAL OSTEOTOMY
AKIN OSTEOTOMY
OTHER PROCEDURES ON THE FIRST RAY
METATARSAL OSTEOTOMY
CLAW TOE CORRECTION
CALF LENGTHENING
An osteotomy is a cut in the bone made to change its shape or position. They are usually fixed with screws until these cuts consolidate; afterward, they are not necessary, although they are only removed if they cause discomfort. In claw toes, we typically place pins that remain visible as they are removed after a month.
