Hallux valgus is a disease more common in children and women and of an orthopedic nature. It is distinguished by the curvature of the axis of the foot, when the middle part of it descends and thickens. In addition, deformation of the big toe, a characteristic bump and musculo-ligament balance may appear.
Other names of the disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue when walking, curvature of the axis of the foot.
The treatment is carried out by an orthopedist-traumatologist.
An article intended for patients with an illness diagnosed by a doctor. Does not replace a doctor's appointment and cannot be used for self-diagnosis.
Causes
Valgus deformity of the feet almost always has a complex nature of formation. In most cases, there are combinations of the following prerequisites:
- Flat feet, congenital and acquired. Due to its presence, weight and pressure are unevenly distributed, leading to deformity of the toes.
- Osteoporosis, characterized by loss of bone stiffness and low calcium.
- Obesity, excess weight, which causes excessive stress on the bones, especially with muscle weakness.
- Hereditary predisposition, 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 tight and uncomfortable high-heeled shoes. In this case, the correct load on the foot is disrupted and the risk of hallux valgus deformation increases.
- Injuries, such as a heavy object falling on the leg, a fracture or bruising, can lead to deformity of the foot.
- Concomitant diseases of the endocrine system, neurological nature.
- Strong fluctuations in hormones, especially 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 focus is on therapeutic treatment.
Steps 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 deviates. The greater it is, the more serious the degree of pathology. According to her:
- Stage I -15°;
- II-20°;
- III-30°;
- IV - more than 30°.
To fully assess the degree of hallux valgus deformity of not only the first toe, but also the posterior toe. There is a classification based on the installation of the heel in relation to the axis of the tibia:
- Stage I - presence of flat feet, but slight deviation of 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.
Generally, depending on the severity of the situation and the degree of curvature, the following types of nature of the course of the disease are distinguished:
- lung;
- average;
- heavy.
Due to their formation, foot deformities are divided into the following types:
- structural, caused by congenital pathology;
- static, caused by curvature of the spine;
- spastic, resulting from overexertion or muscle tone;
- traumatic deformity of the foot;
- rickety and others.
So, there are many types of deformities of the first toe and other parts of the foot. To determine the features of the course of the disease, it is necessary to consult a doctor and undergo examinations.
Symptoms
The particularly insidious nature of the pathology lies in the fact that it does not manifest itself 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 begin once the disease has reached a more serious stage, making treatment more complicated and longer.
Manifestations of hallux valgus can vary and include the following:
- fatigue when walking;
- corns;
- 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 a "toe bone";
- deformity of the remaining toes, which become hammer toes.
As the foot deformity progresses, the patient finds that the shoes he previously wore no longer fit him. It becomes narrow and uncomfortable due to the increasing thickening of the tissues, the appearance of new calluses and the addition of bursitis.
Finding shoes becomes difficult, sometimes almost impossible. In advanced stages of hallux valgus, the pain intensifies and constantly increases, discomfort in the knee and hip joints is noted, 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 with a cosmetic problem.
Complications
One of the terrible consequences of lack of therapy is not only the progression of the pathology, but also the addition of other related problems. With the development of hallux valgus, negative consequences may occur. The most common are:
- Bursitis, namely inflammation of the synovial bursae. This problem results in swelling and pain in certain areas of the foot due to deformities of the joints of the foot.
- Osteoarthritis is the destruction of cartilage, which leads to reduced joint mobility, pain and gait disturbances.
- Increased load, due to which the knee joint wears out, pressure on the spine increases and osteoarthritis occurs.
- Formation of a heel spur. In this case, sharp, almost unbearable pain appears when walking.
- Achilobursitis and other diseases.
In addition, hallux valgus always poses a serious aesthetic problem, particularly visible when wearing open shoes. This causes great psychological discomfort in a person, which can negatively affect his general psycho-emotional state.
To avoid negative consequences, it is necessary to undergo timely treatment. The medical center employs experienced doctors who help patients with any form and degree of valgus.
Diagnosis
At the first appointment, the orthopedist-traumatologist conducts a complete examination and examination of the patient. To do this, he visually assesses the condition of the feet, their location, deviations, and determines the presence of forefoot deformation. However, this is not enough to draw a definitive conclusion about the extent and nature of the problem, so additional studies are ordered.
Instrumental methods
One of the main ways to evaluate hallux valgus is with a three-projection x-ray. It not only helps identify this problem, but also identifies a number of others, including subluxations, dislocations and osteoarthritis. It is based on the results of this examination that it is possible to estimate the magnitude of the deviation of the angles, make calculations and correctly prescribe treatment for hallux valgus.
For a more detailed study of the hallux valgus deformation or, if necessary, additional studies are prescribed:
- Ultrasound can help identify disorders in the functioning of blood vessels if local circulation problems are suspected.
- 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, which allows you to identify and determine the degree of flat foot.
- Podoscopy is an examination of the soles in a standing position.
There are no specific laboratory research methods for diagnosing hallux valgus in adults and children. Usually the listed methods of examination are sufficient, but if necessary, the doctor may prescribe others.
Hallux valgus can resemble other conditions, making differential diagnosis particularly important. Among the most common are:
- drop;
- osteoarthritis;
- arthritis.
The modern medical clinic has the latest diagnostic equipment. This allows you to quickly identify hallux valgus and conduct a comprehensive examination and therapy.
Hallux valgus treatment
Today, specialists have several methods to help patients with foot deformities. Even the first stage of treatment may vary depending on the characteristics of a particular case. If the degree of the disease is already serious, hallux valgus in adults sometimes begins immediately with surgical intervention.
Conservative methods
There are many ways and techniques to avoid surgical treatment, especially in the early stages of the development of pathology. Among the most common are:
- Wear orthopedic shoes. It should be fixed rigidly, with a stable, low heel and an elongated toe. Additionally, special insoles, bolsters and other devices can be used to eliminate excessive load on 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 course. The exercise therapy instructor selects a program for a specific patient and also teaches the correct technique for performing the exercises. It is important to consult a specialist first.
- Foot massage. This should be done only in specialized medical centers, since it is aimed not so much at relaxation as at the treatment of valgus.
- Take nonsteroidal anti-inflammatory drugs, both to reduce the inflammatory process and to relieve pain. It is important to consult a doctor before using such medications.
- Good nutrition, a diet enriched with calcium.
Additionally, the use of physiotherapeutic procedures in the treatment of hallux valgus is useful, which may include:
- phonophoresis;
- Ultra-high frequency;
- magnetotherapy.
When treating hallux valgus, it is recommended to avoid prolonged standing and to concentrate your efforts on strengthening the muscles and ligaments.
All of these hallux valgus treatment methods can be used in combination or separately. The course is developed by the doctor depending on the situation and the complexity of the particular case. However, they are more suitable for treating patients with early-onset hallux valgus or early-onset hallux valgus.
Surgical methods
If conservative treatment of foot deformities turns out to be ineffective or the problem is detected at a late stage, surgical intervention is performed. This has advantages, because the problem is solved in one step, whereas with non-surgical treatment of deformities of different parts of the foot it often takes several years.
Today, doctors carry out appropriate manipulations, which come in many varieties. It depends on the type of procedure that will be relevant for a particular patient. According to this criterion, operations to correct hallux valgus are distributed as follows:
- On soft tissues. In this case, the treatment of hallux valgus in children and adults in the early stages of the development of pathology can be the use of the Silver and McBride technique. They only concern stage I of the disease.
- Combination of effects on bony and soft tissue structures to treat foot deformities, e. g. Schede's operation.
- On the bones. This type of procedure is called osteotomy, which has many varieties. It is most often used for moderate to severe foot deformities in adults.
Modern methods of surgical treatment of patients with foot deformities make it possible, in many cases, to carry out intervention percutaneously or using a laser, for example, resurfacing the "bone" for thehallux abducto valgus. If it is possible to perform a type of minimally invasive therapy for hallux valgus deformities, the advantages are obvious:
- rapid rehabilitation times;
- absence of large incisions and seams;
- eliminate 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 state. However, the doctor takes into account the individual structure of the patient's legs, because it is unique.
Recovery after surgery to correct hallux valgus takes varying times: from 2 weeks to 4 months, depending on the extent of the intervention and its complexity. During the recovery period, you will need to wear special shoes, follow the doctor's recommendations and take medication.
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 year, when the child begins to walk. Sometimes a pediatrician notices a deviation, can show it and refer you to a consultation with an orthopedist.
If you consult a doctor in a timely manner, the situation can be corrected using conservative therapeutic methods. If the baby's arch is in a valgus position, in most cases the problem can be resolved without surgery.
If at an early age, when putting the feet down, a valgus curvature is formed, massage, physiotherapy and physiotherapy are used. However, one of the main ways to remedy the situation is to wear orthopedic shoes. It is selected individually; As the child grows and the angle of the foot changes, it needs to be replaced.
Surgical treatment is used extremely rarely, and the question of its choice is always approached individually. With a slight degree of damage, they try not to use radical treatment.
The prognosis for treatment of deformities 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 completely restore the normal appearance and functionality of the foot.
Which doctor treats you?
Treatment of hallux valgus is traditionally carried out by an orthopedist-traumatologist. It is this specialist who will help the patient if the first symptoms of the disease are noted or for prevention purposes. In case of illness in children, the specialist must have the skills and experience to care for these patients. If radical treatment of hallux valgus is necessary, the participation of a surgeon will be required.
Forecast
With proper and timely treatment, hallux valgus deformity can be successfully eliminated. In most cases, it is possible to stop the pain and achieve the desired cosmetic aesthetic effect. The therapy is especially effective in young children, as well as at an early stage in the development of the problem.
However, this is feasible if you follow all the recommendations of the specialist, as well as in case of early diagnosis. In serious situations, treatment of hallux valgus is also possible, but it will take more time and involve the use of more serious methods of intervention. There is a risk that it will not be possible to completely restore the original state of the foot in particularly advanced cases.
Prevention
There is no reliable way to permanently prevent hallux valgus. It is multifactorial in nature and is often due to a genetic predisposition. However, there are several ways to reduce the risk of its appearance or eliminate it at an early stage of development:
- regular preventive examination by an orthopedist-traumatologist;
- rapid detection and treatment of flat feet;
- wear comfortable shoes, excluding stiletto heels for women;
- if necessary, use of orthopedic insoles;
- weight control, maintaining it in a normal and optimal state;
- compliance with the norms of rest and work, especially if a person's professional activity is associated with increased load on the legs;
- an adequate and balanced diet, abandoning bad habits;
- a moderate level of physical activity, which implies the absence of both physical inactivity and excessive stress on the legs.
In a modern medical center, you can undergo modern diagnosis and treatment of hallux valgus at any stage of its development.