Encyclopedia

Hallux Valgus

Hallux Valgus is a vagus deformity of the big toe in the metatarsophalangeal joint. Due to the deformity, the thumb deviates outward at an angle to the others.

The disease is diagnosed 10 times more often in women than in men.

It is assumed that the reason for this difference is the weakness of the tendons in the fairer sex, and also due to wearing uncomfortable tight shoes with high heels.

The pathology is widespread and is found in people of all ages.

What are the symptoms?

Patients complain of pain in the area of ​​the first metatarsophalangeal joint.

Painful sensation intensifies after prolonged walking or prolonged standing and weakens at rest. Pains are also possible at night, especially after a heavy load on the legs.

The pain syndrome can differ significantly both in character and intensity – from a slight feeling of discomfort /in the initial stages/ to severe burning or constant pain.

Intensity of the pain syndrome does not always clearly correlate with the size of the deformity, although with a significant displacement of the head of the first metatarsal bone, the symptoms are usually more pronounced.

What are the causes?

The main reason for the development of the deformity is usually inadequate connective tissue, which can manifest as transverse flat feet, excessive joint mobility, enlarged veins, increased extensibility of tendons, fascia and skin.

In most cases, a hereditary predisposition is detected – usually the closest relatives of the sick /mother, grandmother/ also have this deformity.

Other factors such as high heels, walking in uncomfortable, tight, tight or short shoes are secondary and only contribute to the formation of the distortion.

Treatment of Hallux Valgus

The deformity cannot be corrected without surgery.

However, in the early stages of the disease in younger patients, and also for any degree of distortion in people of advanced or senile age, conservative therapy is recommended.

The main goals of such therapy is to eliminate the pain syndrome and prevent the progression of the disease.

Patients are advised to:

• Weight reduction of excessive body weight to reduce the load on the leg;

• Optimizing the load – a special set of exercises should be performed to strengthen the tendons and muscles of the legs and possibly avoid prolonged standing and walking.

• Use of special orthopedic shoes to eliminate excessive pressure on the area of ​​the first metatarsophalangeal joint.

• The use of plates between the first and second toes to prevent further vagus deviation of the 1st toe.

Anti-inflammatory and warming ointments are recommended for pain.

In a period of remission in arthrosis of the 1st metatarsophalangeal joint, ozokerite or paraffin, phonophoresis with hydrocortisone, electrophoresis with novocaine or trimecain are prescribed.

If there are signs of inflammation, the patient is directed to therapy with ultrahigh-frequency currents or magnetotherapy.

There are about 300 methods for surgical treatment of the disease.

All surgical techniques can be divided into 3 groups:

• Surgical intervention of soft tissues;
• Bone surgery;
• Combined bone and soft tissue surgery.

Soft tissue surgery is effective only for 1st degree deformity. It is possible to perform Silver’s operation, in which the tendon of the adductor muscle of the 1st thumb is cut.

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