Hallux Valgus

Hallux Valgus is a deformity of the base joint of the big toe. The cause is not clear in many cases. The deformity may cause the foot to rub on shoes which may cause inflammation and pain.

What is Hallux Valgus or Bunion?
A bunion is when your big toe is angled towards the second toe. This causes a bump on the side at the base of the big toe. In addition there is often thickening of the skin and tissues next to the affected joint. The thickened skin and tissues may become inflamed, swollen and painful. 

 

 

 

 

 


Severe deformity

What causes bunions?
The underlying cause is a deformity of the joint at the base of the big toe. The deformity is called hallux valgus. In this deformity the joint develops a prominent sideways angle. Due to this deformity the bones of the big toe are pushed towards the smaller toes.


The intermetatarsal angle is increased in the affected foot.

In most cases it is not clear why a hallux valgus deformity develops. There may be some genetic tendency to have a weakness of this joint. In some cases it is associated with a joint problem such as osteoarthritis or rheumatoid arthritis.

However, whatever the underlying cause, wearing tight or badly fitting shoes tends to make the problem worse.
What symptoms and problems are caused by bunions?
• Pain. You may then have difficulty walking due to pain.
• Inflammation and swelling at the base of the toe. This sometimes becomes infected.
• The foot may become so wide that it can be difficult to find wide enough shoes.
• You may get arthritis in the big toe.
• The second toe can become deformed.
• In severe cases, the big toe can push your second toe up out of place.




What symptoms and problems are caused by bunions?

  • • Pain. You may then have difficulty walking due to pain.
  • • Inflammation and swelling at the base of the toe. This sometimes becomes infected.
  • • The foot may become so wide that it can be difficult to find wide enough shoes.

 

Severe deformation

crossover deformity

What is the treatment for bunions?
Good footwear is often all that is needed

Wearing good footwear does not cure the deformity but may ease symptoms of pain and discomfort. Ideally, get advice about footwear from a podiatrist or chiropodist. 

Advice may include:Wear shoes, trainers or slippers that fit well and are roomy.Don't wear high-heeled, pointed or tight shoes.You might find that shoes with laces or straps are best, as they can be adjusted to the width of your foot.Padding over the bunion may help, as may ice packs.Devices which help to straighten the toe (orthoses) are still occasionally recommended, although trials investigating their use have not found them much better than no treatment at all.

 


Οrthotics

 

Medication
Paracetamol or ibuprofen may ease any pain. If the bunion develops as part of an arthritis then other medication may be advised.

Surgery
An operation may be advised if a change of footwear does not ease symptoms. The aim of the operation is to straighten the joint as much as possible and relieve pain. It is not usually done just to improve appearance.



Correction osteotomies


1rst metatarsal osteotomy & 1rst phalanx osteotomy


1rst metatarsal osteotomy


1rst phalanx osteotomy


Arthrodesis


Minimally Invasive Technique in Ηallux Valgus Surgery
A new Method


By this method:
The procedure takes 20-30 minutes and is painless, performed under local anesthesia , no ischemic bandage is used, no postoperative scarring and postoperative period is short and painless also.

The patient returns home immediately. Technically, a small tool is used, at the size of a pencil, the burr, which works in a "closed" fashion. The doctor uses a C-ARM radio grapher to be precise in the degree of correction.


Foot under C-ARM in order to have accurate cuts






Micro-tiny tools for shaving and cutting the bone.


Micro-tiny tools for shaving and cutting the bone.


Using a small tiny burr remove the bunion.


Scar tissue and tendon release to the other side, for a better correction.


The osteotomy of the 1rst metatarsal is done under fluoroscopic control.


Deformation correction manually.


Correction and re-alignment.

http://www.windsorfoot.com/uploads/Darco%20shoe.jpg
Tapping. Custom made shoe.

We should emphasize that the method is simple, spectacular, with very good results but has limited evidence, depending on the severity of each case. Finally, we must say that the surgeon decides upon the right technique in any case, not just proceeding to the technique that looks a promising one. This is also a key rule in surgical practice.

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