Hallux valgus is a disease that occurs more often in children and women and is orthopedic in nature. It is characterized by the distortion of the axis of the foot, when its middle part descends and thickens. In addition, a deformity of the big toe, characteristic swelling and musculo-ligament imbalance may occur.
Other names of the disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue when walking, distortion of the axis of the foot.
The treatment is carried out by an orthopedic traumatologist.
Article for patients with a medically diagnosed disease. It does not replace a doctor's examination and cannot be used for self-diagnosis.
reasons
Valgus deformity of the legs almost always has a complex nature of formation. In most cases, combinations of the following prerequisites are available for this:
- Flat feet, both congenital and acquired. As a result of its presence, weight and pressure are distributed unevenly, which leads to deformation of the toes.
- Osteoporosis, which is characterized by loss of bone hardness and low calcium.
- Obesity, excess weight that causes excessive stress on the bones, especially with muscle weakness.
- Hereditary predisposition, when the connections 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, tight, high-heeled shoes. In this case, the proper loading of the foot is disturbed and the likelihood of hallux valgus deformity increases.
- Injuries such as a heavy object falling on the foot, a fracture or contusion can cause a foot deformity.
- Concomitant diseases of the endocrine system, neurological in 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 due to 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 greatest emphasis is placed on 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 at which the big toe deviates. The larger it is, the more serious the degree of pathology. According to her:
- Stage I -15°;
- II - 20°;
- III - 30°;
- IV - more than 30 °.
For a complete evaluation of the degree of hallux valgus deformity not only of the first toe, but also of the back toe. There is a classification that is based on the mounting of the heel relative to the axis of the tibia:
- I stage - presence of flat feet, but 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 nature of the course of the disease are distinguished:
- lung;
- average;
- heavy.
Due to the formation, foot deformities are divided into the following types:
- structural, which is caused by congenital pathology;
- static, caused by curvature of the spine;
- spastic, as a result of overexertion or muscle tone;
- traumatic deformation of the leg;
- rachitic etc.
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 particular insidiousness of the pathology lies in the fact 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 quick feeling of fatigue after walking. Obvious problems begin only after the disease reaches a more serious stage, which complicates the treatment and prolongs it.
Manifestations of hallux valgus can vary and include the following:
- fatigue when walking;
- corns;
- corns that appear regularly, constantly in the same places;
- pain;
- increased swelling of the lower limbs;
- deviation of the thumb to the side;
- the formation of a characteristic protrusion, which is often called the "bone of the toe";
- deformity of the remaining fingers, which become hammer toes.
As the foot deformity progresses, the patient notices that the shoes he used to wear no longer fit him. It becomes narrow and uncomfortable as a result of increasing thickening of the tissues, the appearance of new calluses and the addition of bursitis.
Finding shoes becomes difficult, sometimes almost impossible. In an advanced stage of hallux valgus, the pain constantly increases, intensifies, discomfort is noticed in the knee and hip joints, 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 the addition of other related problems. With the development of hallux valgus, negative consequences can occur. The most common are the following:
- Bursitis, namely inflammation of the synovial bursae. This problem is expressed in swelling and pain in certain areas of the foot as a result of deformations 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, the pressure on the spine increases and arthrosis occurs.
- Heel spur formation. In this case, a sharp, almost unbearable pain occurs when walking.
- Achilles bursitis and other diseases.
In addition, hallux valgus always represents 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.
In order 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 initial 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 deformation of the front part of the foot. However, this is not enough to make a final conclusion about the extent and nature of the problem, so additional studies are appointed.
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 study, it is possible to estimate the magnitude of the deviation of the angles, make calculations and correctly prescribe a course of treatment for hallux valgus.
For a more detailed study of the hallux valgus deformity or, if necessary, additional studies are prescribed:
- Ultrasound can allow to identify disorders in the functioning of blood vessels if there is a suspicion of problems with local blood circulation.
- Computed tomography or nuclear magnetic resonance will help to exclude other pathologies similar to hallux valgus and to obtain a more detailed picture of the disease.
- Plantography, which allows you to identify and determine the degree of flat feet.
- Podoscopy is an examination of the sole in a standing position.
There are no specific laboratory research methods for the diagnosis of hallux valgus in adults and children. Usually, the listed research methods are sufficient, but if necessary, the doctor can prescribe additional ones.
Hallux valgus can resemble other diseases, which makes the differential diagnosis especially important. Among the most common are:
- gout;
- osteoarthritis;
- arthritis.
The modern medical clinic has the latest diagnostic equipment. This allows you to quickly identify hallux valgus and conduct a complete examination and therapy.
Treatment of hallux valgus
Today, specialists have a number of methods available to help patients with foot deformities. Even the first stage of therapy can vary depending on the characteristics 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 techniques that help to avoid surgical treatment, especially in the initial stages of 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, pads and other devices can be used to remove excess load 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.
- Physical therapy classes. The exercise therapy instructor selects a program for a specific patient and also teaches the correct technique for performing the exercises. At the first stage, it is important to consult a specialist.
- Foot massage. This should be done only in specialized medical centers, as it is aimed not so much at relaxation as 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 a doctor before using such drugs.
- Proper nutrition, diet enriched with calcium.
In addition, the use of physical therapy procedures in the treatment of hallux valgus is beneficial, which may include:
- phonophoresis;
- UHF;
- magnetotherapy.
During the treatment of hallux valgus, it is recommended to avoid prolonged standing and focus your efforts on strengthening the muscles and ligaments.
All of these methods for treating hallux valgus can be used in combination or individually. The course is developed by the doctor depending on the situation and the complexity of the specific case. However, they are more suitable for treating patients with early hallux valgus or early stage hallux valgus.
Surgical methods
If the conservative treatment of foot deformities is ineffective or if the problem is detected at a late stage, surgical intervention is performed. It has its advantages, since the problem is solved at one stage, while in non-surgical treatment of deformities of different parts of the foot it often takes several years.
Today, doctors perform appropriate manipulations that have many varieties. It depends on what type of procedure will be suitable for a particular patient. According to this criterion, operations to correct hallux valgus are divided into the following:
- On the soft tissues. In this case, the treatment of hallux valgus in children and adults in the early stages of development of the pathology can be the use of the Silver and McBride technique. They are relevant only for the I stage of the disease.
- A combination of effects on bone and soft tissue structures for the treatment of foot deformities, for example Schede's operation.
- On the bones. This type of intervention is called an 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 allow in many cases to carry out the intervention percutaneously or with the help of a laser, for example, restoring the "bone" in hallux abducto valgus. If it is possible to carry out a minimally invasive type of therapy for hallux valgusvalgus deformities, the advantages are obvious:
- rapid rehabilitation;
- lack of large incisions and seams;
- 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 state. However, the doctor takes into account the individual structure of the patient's feet, as it is unique.
Recovery after surgery to correct hallux valgus takes a different time: 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 use 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 one year, when the child is walking. Sometimes the pediatrician notices a deviation and can show it and refer you for a consultation with an orthopedist.
If you consult a doctor in time, the situation can be corrected using conservative treatment 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 a valgus curvature is formed when placing the feet, massage, physiotherapy and physiotherapy are used. However, one of the main ways to correct the situation is to wear orthopedic shoes. It is chosen individually, as the child grows and the angle of the foot changes, it must be changed.
Surgical treatment is used extremely rarely, and the question of its choice is always approached individually. With a small degree of damage, they try not to use radical treatment.
The prognosis for treatment of deformities of the first finger and valgus in general in children is often positive. By following all the doctor's recommendations and systematic monitoring, it is possible to completely restore the normal appearance and functionality of the leg.
Which doctor treats you?
The treatment of hallux valgus is traditionally carried out by an orthopedic traumatologist. It is this specialist who will help the patient if the first symptoms of the disease are noticed or for the purpose of prevention. In case of illness in children, the specialist should have skills and experience in managing such patients. If radical treatment of hallux valgus is necessary, the participation of a surgeon is necessary.
Forecast
With proper and timely therapy, the 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 particularly successful in young children, as well as in the early stages of the problem's development.
However, this is possible if you follow all the recommendations of the specialist, as well as with early diagnosis. In severe situations, hallux valgus treatment is also possible, but it will take more time and involve the use of more serious intervention methods. There is a risk that it will not be possible to completely restore the original condition of the leg in particularly advanced cases.
Prevention
There are no reliable ways to definitely prevent hallux valgus. It is multifactorial in nature and is often due to a genetic predisposition. However, there are a number of ways to reduce the risk of its occurrence or to eliminate it at an early stage of development:
- regular preventive examination by an orthopedist-traumatologist;
- timely detection and treatment of flat feet;
- wearing comfortable shoes, except for high heels for women;
- if necessary, use of orthopedic insoles;
- weight control, maintaining it in a normal, optimal state;
- compliance with the standards of rest and work, especially if a person's professional activity is associated with increased load on the legs;
- proper and balanced nutrition, rejection of bad habits;
- a moderate level of physical activity, which implies the absence of both physical inactivity and excessive load on the legs.
In a modern medical center, you can undergo modern diagnosis and treatment of hallux valgus at any stage of its development.