Halluks Valgus

Hallux valgus disease is a disease that affects the joint between the big toe and the first metatarsal bone. The swelling and protrusion on the big toe is called ‘bunion’.

Bunion disease is the most common cause of big toe pain.

This disease is also found in cultures that do not wear shoes. However, bone spurs on the big toe are more common in women who wear shoes with heels and pointed toes. Wide shoes that provide plenty of space for the toes reduce the likelihood of developing the deformity and reduce the existing protrusion and associated irritation.

How does Hallux Valgus develop? What problems does the protrusion of the thumb cause?

In Latin, Hallux is the name given to the big toe, while Valgus is the angulation of the big toe away from the midline of our body. Therefore, hallux valgus is a complex orthopedic disorder in which the 1st toe is directed towards the outside of the foot.

The first metacarpal bone approaches the midline of the body and the joint begins to strain, followed by the angulation of the big toe towards the outside of the foot (from the midline of the body to the side). The bump on the big toe, the bunion, is actually a swelling caused by the pressure of the hard leather part of the shoe on this angulation area. In this area, redness develops around the swelling due to constant irritation. As time passes, the skin here gradually thickens and turns into a larger protrusion that causes the shoe to rub and discomfort occurs. As the thumb continues to splay to the side, the second toe is raised (rarely it can be lowered) and the deformation is aggravated. A callus forms under the second toe, eventually causing a cosmetic problem.

Who is more likely to have a bone spur on the thumb?

Hallux Valgus is usually a genetically transmitted problem between family members, but it can also be associated with other diseases.

People with flat feet (Pes Planus),
People with high arch (Pes Cavus),
People with weight problems (due to increased load on the feet),
It appears in people with some rheumatic problems.

What are the conditions associated with Hallux Valgus?

When thumb protrusion is left untreated, various deformities can be seen in other toes as the disease progresses.

Deformities of the little fingers: Deformities caused by two fingers overlapping each other or due to looseness of the fingers and the resulting callus, open wound

Morton’s Neuroma: It is a painful condition caused by compression and consequent enlargement of the nerve located between the third and fourth metacarpal bone (rarely between the fourth and fifth metacarpal bone).
Bunionette (protrusion of the fifth toe of the foot): This is a condition in which the fifth toe of the foot turns inward over time.

How is Hallux Valgus Disease diagnosed? What treatment options are there for thumb protrusion?

The disease is diagnosed after a careful, detailed medical history and examination.

Patients are informed about their choice of footwear. X-rays of the foot are taken and the angles between the bones are measured to determine treatment methods.

Hallux Valgus Disease Treatment Options

Non-Surgical Treatments:

Hallux valgus treatment starts with the selection of shoes suitable for the foot. In the early stages of the disease, replacing shoes with shoes with a wide front can reduce complaints. Wide shoes reduce the pressure on the bunion and are useful in reducing pain.

In addition, applications such as bunion pads, finger rollers and night splints can be used to reduce pressure and pain.

Although these devices may relieve pain (they do not always work), they will not completely correct the deformity or make the protrusion disappear.

To reduce bunion pain:

Correct selection of shoes that are constantly used,
The use of insoles to prevent the defect of the foot according to the type of foot,
Silicone sleeve to protect painful calluses on the little fingers.

Surgical Options for Thumb Protrusion:

If all non-surgical methods fail to relieve the patient’s pain and the patient wants the deformity to be treated, surgical correction is performed.

Who Should Have Hallux Valgus Surgery?

Surgery is performed on people who have developed excruciating pain in the big toe. For non-painful big toes, surgery is not recommended.

A wide variety of surgeries have been described in the surgical treatment of hallux valgus disease. The aim of these surgeries is ;

Eliminating the protrusion on the thumb, also known as Bunionectomy (removal of the bunion)
To ensure the smoothness of the bones forming the first finger
To provide muscle balance around the joint to prevent recurrence of the deformity.

Are hallux valgus surgeries very painful?

The most effective treatment of hallux valgus is surgical correction. Since the procedures to be performed require incisions in the bones, an effective anesthesia should be performed during surgery.

With the measures to be taken by the orthopedic-anesthesia team during and after the operation, you will not have much pain after the operation. Before I forget; pain threshold intensity varies from person to person.

When will I be able to walk after hallux valgus surgery?

The short answer is now.

Since bone correction is performed in hallux valgus surgeries, no load should be given until the bone healing in the operated area is completed. This is a process of approximately 6 (six) weeks. You will use special shoes so that you can step on your foot and walk. This shoe will not have a front part and will allow you to walk by pressing on the heel.

You should not walk for a long time, it is important not to let your foot hang down as swelling may occur around the foot.

How long after Hallux Valgus Surgery can I wear normal shoes? How long after Hallux Valgus Surgery can I wear high heels?

After the bone fusion is complete, you will be able to wear your everyday shoes. This period is usually around six weeks. After the swelling in the feet and fingers goes down, you will be able to wear high heels if there is no cartilage disorder in the thumb joint. However, I believe that you should not wear heels more than 8 cm.

Can I do sports after Hallux Valgus surgery?

After the bone fusion is completed, normal movements of the big toe will be restored in about 2-3 months. After this time, you will be able to do active sports.

Does Hallux Valgus recur after surgery?

After surgical correction of the deformity of the big toe, the disease will not recur unless there is another cause that disrupts the mechanics of the foot. The risk of recurrence varies according to the type of disease and the type of surgery to be performed.
Scientific research has shown that with the right patient selection and the right surgical technique, the majority of patients feel much better after hallux valgus surgery than before. Hallux Valgus surgeries are among the most common orthopedic surgeries.

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