Hallux valgus is a pathological change in the shape of the metatarsophalangeal joint, leading to curvature of the big toe. If left untreated, the disease is accompanied by the formation of a lump, causing discomfort and pain while walking.
Most often, bunions are the result of transverse flatfoot in people with an individual anatomical predisposition. With high elasticity (hypermobility) of the joints, an imbalance of the capsular-ligamentous apparatus occurs, causing deviation towards the first metatarsal bone. In addition to flat feet, there are other causes of hallux valgus:
In some cases, bunions occur due to mechanical damage to the joints of the foot. According to statistics, pathology occurs more often in women; their muscles and ligaments are weaker and more elastic.
Hallux valgus in the early stages of development is characterized by hyperemia (redness of the skin) and slight swelling. Usually the metatarsal bones on both feet are deformed. When the first symptoms appear, you should consult an orthopedic doctor for diagnosis and treatment.
In the absence of timely treatment, the pathology progresses, aching pain appears, which intensifies when walking. Over time, the fingers become more and more deformed, nails begin to grow in, calluses and corns form. The development of purulent bursitis, arthritis or osteomyelitis is possible.
Depending on how many degrees the thumb is deviated, there are 4 degrees of valgus deformity.
Treatment for hallux valgus depends on the stage of the disease. In the first stages, complex therapy is used, which often only stops the deviation of the metatarsal joint. Stopping the growth of the bone is possible only in certain cases.
Devices such as a valgus corrector support damaged joints, evenly distributing the load across the entire foot. Gradually the finger returns to its natural position, pain and discomfort disappear. The devices are made from different materials and are designed to be worn during the day or during the night. You can buy a corrector for hallux valgus at a pharmacy or a specialized online store. It is better to coordinate the choice of model with your doctor.
Shock wave treatment, which includes hydrocortisone phonophoresis, ozokerite-paraffin applications, and electrophoresis, is carried out in a hospital setting. The procedures break up the cartilage growth, relieve pain and speed up the healing process; they are prescribed in the last stages of the disease.
Medicines that relieve inflammation and pain in damaged joints are an integral part of complex therapy. Ointments can be purchased at a pharmacy or prepared yourself. You should not use medications without the recommendation of an orthopedist. Only a specialist, based on the degree of joint deformation, can determine the advisability of using a particular drug.
Gymnastics for hallux valgus is used both to treat the first stages of the disease and as preventive measures.
Doctors prescribe special exercises that relieve swelling, develop joints damaged by the disease, and reduce pain. To perform gymnastics you do not need special conditions, the main thing is regularity. Exercises may be different, but some are considered particularly useful:
Conservative treatment is more effective when combined with a special massage that removes muscle spasms and restores joint mobility.
Surgery for hallux valgus is prescribed when the disease is severely advanced and other means are no longer effective. The techniques may be different, it all depends on the degree of joint deviation and the patient’s requirements. Before the procedure, it is necessary to undergo appropriate tests, take an x-ray of the damaged area and an ultrasound of the veins of the lower extremities.
The operation most often consists of the following manipulations:
At the end of the procedure, sterile dressings and an elastic bandage are applied; the leg, as a rule, is not cast. Titanium screws are removed after 1–1.5 months.
There are practically no complications after surgery. Only in some cases does the bone form again. The duration of rehabilitation depends on the degree of joint deviation and the treatment used previously. The complex of restoration procedures consists of:
Reviews about the operation vary, but more than 80% of patients are satisfied with the result. The main thing is to wear comfortable shoes and avoid strenuous physical activity for a year after the procedure.
Prevention of the disease includes several proven methods:
When the first unpleasant symptoms appear, it is better to consult a specialist. After a comprehensive diagnosis, he will tell you how and how to treat hallux valgus. Only timely adequate therapy will help avoid surgical intervention.
A bunion deformity is an injury to the joint of the big toe . Very often this deformity is called joint bursitis. This disease occurs due to the formation of a bone growth on top of an existing injury. When the big toe is deformed, not only severe cosmetic changes in the foot occur, but also a number of pathological disorders in the ligaments, tendons and joints.
As medical statistics show, bunion deformity occurs due to constant pressure or friction on the big toe . Most often, this pressure is exerted by uncomfortable and tight shoes. The main causes of big toe deformity:
The most common symptom of toe deformity is a common disease called bunion . This is a very painful disease that causes a lot of inconvenience. A cosmetic problem also appears (the big toe begins to deform and deviate to one side). Severe pain occurs when wearing uncomfortable shoes.
In our center of traumatology and orthopedics at Clinical Hospital No. 85 of the Federal Medical and Biological Agency of Russia, there are several methods for treating toe deformities. Let's look at them:
Conservative treatment of toe deformities begins, first of all, with the selection of comfortable shoes. Shoes should never cause stress or friction on the big toe. In the early stages of bunion deformity, wearing comfortable shoes can be a good treatment. Pain when a toe is deformed always occurs due to external influences and friction from shoes, so comfortable shoes will also relieve severe pain. Special thumb pads are also widely used. They allow you to bypass the toe, distribute the load evenly on the foot and block friction.
Highly qualified doctors at our center can prescribe anti-inflammatory non-steroidal drugs or physical therapy to reduce inflammation and reduce pain. In many cases, corticosteroid injections are prescribed. Very often, all kinds of orthopedic products are used, such as: toe correctors, instep supports, interdigital rollers. The use of these orthopedic products is very effective, but only in the early stages of big toe deformity . In the later stages of big toe deformity, the use of any orthopedic devices effectively relieves all pain symptoms.
If the cause of the big toe deformity is the presence of systemic diseases or metabolic disorders, then doctors prescribe treatment that is aimed at the causative disease or its correction. Very often, to treat a thumb deformity, it is necessary to undergo examination by an endocrinologist and rheumatologist.
If there are medical indications and there are referral quotas, our center performs operations using funds allocated under the program for the provision of high-tech medical care (HTMC)
This method of treatment is used when conservative or drug treatment is ineffective. Surgical treatment of big toe deformity is aimed at:
Removing the build-up . Often, to treat big toe deformities, only the growth on the joint capsule is removed. During this operation, a small incision is made in the foot in the area of the bunion. Then the growth itself is removed using a special chisel. Then the bone is aligned and the incision is sutured.
Doctor Volobuev Dmitry
conducts preoperative examination
Carrying out the operation when
big toe deformities
Surgery most often consists of:
A distal osteotomy is a surgical procedure in which the distal end of the bone is cut and moved to a lateral position. This operation reduces the angle between the metatarsal bones. During this operation, two incisions are made. After the operation, the bones are fixed using special medical metal pins (they are removed after 4-6 weeks).
A proximal osteotomy is a surgical procedure in which the metatarsal bone is cut at the proximal end of the bone. During this operation, two, maximum three incisions are made on the foot. After the incision, the doctor reconstructs the bone and also secures it with metal pins. This operation is also aimed at reducing the angle between the bones.
Our center for traumatology and orthopedics at Clinical Hospital No. 85 provides high-quality treatment for big toe deformities with excellent results..
Our staff consists of orthopedic traumatologists with extensive practical experience in this field of medical activity. Many doctors at our center for traumatology and orthopedics are candidates and doctors of science. To treat big toe deformities, we use unique treatment methods that have no analogues in Russia. If your big toe is deformed, immediately contact our Traumatology and Orthopedics Center at Clinical Hospital No. 85 for high-quality and effective treatment.
On April 18, 2013, the TVC channel aired the program “Doctor I” in which the orthopedic traumatologist P.L. Zhadan took part. The program touched upon the topic of treatment of flat feet and one of the most common orthopedic pathologies of the forefoot - hallux valgus. The program covered the causes of static foot deformities, prevention and modern methods of treating patients with this orthopedic pathology. We recommend watching the full version of the program on our website.
At this age, conservative treatment of such a pathology is possible, it all depends on the degree of deformity. You need to come for an in-person consultation.
Contact a neurologist.
Yes, a consultation is possible at our hospital. Call the numbers provided on the website.
In our traumatology and orthopedics center, foot surgeries are performed. You need to call the numbers provided on the website and make an appointment.
In our clinic, patients over 18 years of age can receive surgical treatment.
Our clinic treats adult patients.
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Hallux valgus is an orthopedic pathology in which the big toe is deformed at the level of the medial metatarsophalangeal joint with the head of the metatarsal bone deviating inward and the big toe deviating outward.
Hallux valgus is the most common foot pathology. A description of this condition is found in the notes of the doctor Ruselo dated 1769, and the first detailed description belongs to the therapist Hutter (1871).
Hallux valgus deformity was also described in 1911 by G.A. Albrecht, a Russian orthopedic doctor, who noted the connection of this pathology with gout.
One of the causes of hallux valgus was first described in 1852 by Dr. Brock, who associated the occurrence of the deformity with wearing the wrong type of shoe.
Deformation of the thumb with outward deviation occurs mainly in women after 30 years of age. Residents of Russia, American and European countries suffer from this pathology more often than women in the Asian and African regions, which is due to the specifics of footwear.
The frequency of the disease increases with age - at the age of 15-30 years, hallux valgus deformity is detected in 3% of people, from 31 to 60 years - in 9% of people, and 16% in people over 60.
The problem is not only aesthetic in nature - with hallux valgus, the crooked first (big) toe, as the pathology progresses, begins to displace the other toes, provoking the development of their hammertoe deformity.
The disease over time causes pathological changes in all structures of the foot (tendons, ligaments, bones and joints), which leads to the development of:
Normally, the metatarsal bones are located strictly parallel to each other. Under the influence of negative factors, the first metatarsal bone is deformed and deviates to the side (outward), as a result of which a protruding bump of insignificant size is formed on the foot, dysfunction of ligaments and tendons occurs, and loss of their elasticity.
Depending on the severity of the pathology, the following are distinguished:
The main factor that provokes the development of hallux valgus is improperly selected shoes (narrow models that fit the foot, tight shoes with a narrow toe, or high-heeled shoes).
In addition, the development of pathology is influenced by genetic factors and associated diseases.
The development of hallux valgus may be a consequence of:
With valgus deformity of the first toe, the angle between the first and second metatarsal bones increases, and a displacement of the first metatarsal bone is observed. In this case, the big toe, which is held by the adductor muscle, begins to shift outward, and the head of the bone begins to form a “bone” (protruding tubercle).
The tubercle does not allow the thumb to be positioned according to the norm (“look” inward), and the finger gradually deviates outward.
The protruding tubercle constantly experiences friction and pressure when wearing shoes, which leads to inflammation of the mucous membrane of the first metatarsophalangeal joint (bursitis).
Constant pressure also causes changes in the bone tissue in the area of the head of the first metatarsal bone, swelling, pain and increased sensitivity of the “bone” and the tissues around it.
Incorrect angle and change in the location of the thumb provoke premature wear of the main joint, damage to the cartilage and a significant increase in bone growth in size. An increase in the “bone” leads to an increase in its trauma and further development of pathology.
Symptoms depend on the stage of the disease.
At the initial stage the following are observed:
The middle stage is accompanied by:
In the advanced, severe stage the following are observed:
Diagnosis of hallux valgus includes:
If it is necessary to exclude circulatory disorders, vascular ultrasound is prescribed; laboratory tests and CT may be prescribed to exclude associated diseases and in preparation for surgical treatment.
Treatment of hallux valgus can be conservative or surgical.
Conservative treatment is effective only in the early stages of the disease. It begins with the selection of a suitable shoe model that will not cause stress and friction (at the initial stage of the disease, wearing models with wide toes stops the further development of the pathology).
Your doctor may recommend using:
In case of severe deformation, orthopedic products can reduce pain, but the use of these products is not able to completely relieve pain.
Treatment in the presence of an inflammatory process includes:
Exercises to correct hallux valgus include:
In the presence of metabolic, hereditary and systemic diseases, treatment of the underlying pathology is necessary (endocrinologist, rheumatologist and other specialized specialists are involved).
Surgical treatment is used for moderate and severe pathology and the ineffectiveness of conservative treatment (since the disease is chronic, slowly progressive, surgical methods are recommended even for mild hallux valgus deformity).
To eliminate pathology, many surgical techniques are used, which are aimed at:
In case of moderately severe deformity, only the growth on the joint capsule can be removed during surgery. During the operation, the growth is removed through a small incision in the area of the bursitis using a special surgical chisel, after which the bone is leveled and the incision is sutured.
Reconstruction of the thumb and metatarsal bone is also possible.
The need for metatarsal bone reconstruction depends on the angle between the first metatarsal and the second bone (if it is greater than 13 degrees, reconstruction is necessary).
During reconstruction, an osteotomy is performed (crossing the bone to subsequently correct the deformity), which can be:
Osteotomy of the proximal phalanx of the first finger can be:
Trapezoidal resection is also used.
Wedge distal and proximal osteotomies, as well as trapezoidal resection, are aimed at angular correction, which is accompanied by shortening of the finger. With a cylindrical osteotomy, only the length of the finger is reduced. When using any method, rotation of the distal bone fragment is possible.
Rehabilitation takes about 8 weeks. During this period, it is recommended to place the operated leg in a special bandage or in shoes with wooden soles (this will eliminate the likelihood of trauma to the operated area and allow the tissues to regenerate normally). Immediately after surgery, the patient may need crutches.
For severe bursitis, physiotherapy may be prescribed some time after surgery (about 6 procedures). Using correctors and wearing shoes with a wider front allows you to quickly restore normal walking.
Prevention of hallux valgus includes:
Degenerative-dystrophic processes in the joints were previously considered exclusively an age-related disease that affects older people. The diagnosis of arthrosis of the toes is increasingly common at a young age and leads to foot deformity.
Untreated arthrosis has a detrimental effect on the functions of the foot, causing inflammation and pain, as well as exacerbating cartilage deformation. Changes in cartilage tissue may be due to a number of hereditary reasons or the patient’s lifestyle. Below we will look at the causes, symptoms and treatment of arthrosis of the big toe joint.
Osteoarthritis of the big toe is often confused with gouty arthritis due to the similarity in the clinical picture of the diseases. However, the difference is significant.
Arthrosis is a consequence of the destruction of hyaluronic tissue of the joint, and gout is associated with a violation of the metabolism of purine bases.
What is the cause of trophism of the ankle joint cartilage? Big toe deformity is associated with a genetic predisposition to the disease, injuries (fractured toe, dislocation), wearing unsuitable shoes, increased stress on the joints (obesity, heavy or prolonged physical activity), and age-related changes.
Also, the reasons for the development of arthrosis are often professional sports, hypothermia or sudden climate change, concomitant disease of the joints of the legs (valgus, flat feet), hormonal changes during pregnancy, taking hormonal medications or pathologies of the endocrine system.
IMPORTANT ! The reason why arthrosis of the toes is diagnosed more often in women is the wearing of beautiful, but not always comfortable, high-heeled shoes, often and for a long time.
When examining the phalanges of the toes, arthrosis is diagnosed by the characteristic sign of joint deformation. Let's look at these signs in more detail.
The disease develops in three stages, each of which is characterized by its own clinical manifestations:
Further changes in the cartilage lead to an anatomically incorrect position of the big toe relative to the foot (see photo), which interferes with movement.
Deformation of the big toe joint leads to structural and functional changes in the foot, negatively affecting its mobility.
ATTENTION ! Leaving the problem untreated, a person risks losing the ability to lean on the injured limb and fully move.
Elimination of pathology requires an integrated approach, since arthrosis develops under the influence of several factors simultaneously and has a progressive course.
Conservative treatment include medications, massage, physical therapy, and chiropractic practices. In advanced stages, when conservative methods do not contribute to complete recovery, it is recommended to resort to surgical treatment.
Treatment of arthrosis begins with eliminating the uneven distribution of load on the foot using silicone fasteners that cling to the toes and align the position of the big toe relative to the foot.
Also, for the entire period of treatment, the patient is required to select orthopedic insoles for shoes and eliminate traumatic activities.
Pharmacological agents should be taken only after a doctor has explained how to treat arthrosis of the toes in your particular case.
Most often, the specialist prescribes anti-inflammatory non-steroidal drugs such as Diclofenac, Ketorol, Movalis. NSAIDs are taken orally and topically. They are relevant only in the presence of severe pain and swelling.
It is important to understand that neither ointment nor tablets from the NSAID group have a therapeutic effect; they only help eliminate the symptoms of arthrosis.
Physiotherapy in combination with other methods helps to quickly restore the cartilage and soft tissues of the finger joint, relieves acute symptoms during an exacerbation. Laser therapy, ozokerite treatment, electrophoresis, magnetic therapy, mud therapy, and compresses with medical bile are recognized as effective procedures.
Additionally, the doctor includes manual practices, gymnastics and massage in the therapy to restore the functions of the damaged joint. For the healing of cartilage tissue, it is also important to take drugs with glucosamine-chondroitin (Arthra, Theraflex).
The last stage of arthrosis is characterized by complete destruction of the metatarsophalangeal cartilage and is difficult to respond to conservative treatment methods.
In this case, the doctor is forced to resort to surgery .
The operation involves resection of deformed tissues or complete immobilization of the joint using fasteners (arthrodesis). It is also possible to partially remove damaged cartilage with shortening of the phalanx.
After the operation, there is a recovery period (up to 4 months), during which the patient is prescribed the above-mentioned conservative methods to eliminate the symptoms of the disease.
Treatment with folk remedies for arthrosis cannot be considered an effective way to eliminate joint deformation and is used only as an auxiliary measure to strengthen the body’s immune forces and local pain relief.
The most popular remedies are salt baths and compresses for the feet, alcohol dressings, ointments based on lard and bear fat.
You can also pay attention to herbal immunomodulatory decoctions of rose hips, ginger, Rhodiola, ginseng, chamomile, and aloe.
Often, self-medication does not lead to the expected results and only worsens the course of arthrosis. The patient turns to an orthopedist when the disease is already rapidly progressing and conservative therapy alone is not enough.
Therefore, you should not delay contacting a specialist if you experience pain in the joints that you have not previously noticed.
Preventing joint disease is much easier than eliminating its consequences. Easy-to-follow recommendations will help significantly reduce the risk of arthrosis of the ankle and toes:
Joint deformation not only brings physical discomfort, but if it develops over a long period of time, it can lead to disability for the patient. Arthrosis of the toes requires complex therapy using NSAIDs, manual practices, physiotherapy and gymnastics. However, in the last stages the disease can only be treated surgically. The recovery period is from 2 months to six months.
Having noticed the first manifestations of arthrosis (bone aches, increased fatigue, increasing pain during exercise, aching pain at rest), do not delay a visit to a specialist and do not self-medicate.
Toe deformities can be of several types. This unpleasant phenomenon is caused by various factors that depend on the gender and age of the person. The treatment and prevention of this pathology will be discussed.
In the vast majority of cases, curvature of the foot is caused by changes in muscle tone. But deformation can be caused by other reasons. Among them are:
As a result of the arch of the foot dropping, it becomes flat. The muscles and tendons responsible for flexion and extension of the fingers change their tone. This causes them to curl and become deformed.
There are two main types of such pathology:
The pathology affects all toes except the big one. It almost never undergoes such deformation. This pathology causes serious discomfort when moving. Ultimately, this leads to deformation of the metatarsal bones and stiffness of movement.
Hammertoe deformity can be of two types:
In the first case, the bent limb can be straightened with your hands. In the second case, this cannot be done. If you do not pay attention to this pathology, then it is consolidated and becomes fixed. Then it is very difficult to treat. In this case, the shoes rub the calluses at the places of curvature, which causes a number of inconveniences to the person.
The first sign of hammertoes is the appearance of calluses. Further, ulcers appear in place of these calluses as a result of friction. As the disease progresses, the fingers are pulled back and the joints protrude. It becomes difficult for the patient to move. For such a person, it is very important to choose the right shoes. The main thing is that the toe is not too narrow. Then the pressure on the limb will be less.
A claw deformity is not much different from a hammertoe deformity. It's just caused by the tone of another muscle. It causes the same inconvenience and also significantly reduces a person’s quality of life.
A deformity of the big toe is called hallux valgus. This is the most common joint disease in modern medicine. Mostly women suffer from this deformity, and it is associated primarily with wearing high-heeled shoes. With this pathology, the joint is bent and a bone is formed in this place, which can be painful.
At first, this is more of a cosmetic problem, because the bone may not bother you for a long time. But as the disease progresses, pain and swelling appear. The patient has difficulty choosing shoes and experiences discomfort when walking.
In addition to high heels and excessively narrow shoes, flat feet can also lead to this disease, in which the muscles weaken and the load on the foot is distributed unevenly, shifting to the area of the metatarsal bones.
There are several stages of such a phenomenon as deformation of the big toe:
How to straighten crooked limbs? If finger deformity is detected at the initial stage, it can be corrected by performing special exercises:
If the deformation of the toes has gone too far and gymnastics does not help, then there are special orthopedic devices that help alleviate the person’s condition.
In case of pathology caused by hallux valgus, this can be a special abductor bandage-straightener, which is used at night. During the day, you need to wear orthopedic insoles that properly distribute the load.
In the most severe and advanced cases, surgical treatment of the curvature is possible. It consists in the fact that the surgeon removes part of the phalanx, thereby relieving muscle tension, and thereby straightens the affected organ. At the end of such an operation, rehabilitation is required, the duration of which is at least a month.
In any case, this pathology is curable, you just need to seek qualified help. An experienced doctor will select the necessary treatment and alleviate the person’s condition.
A common disease is arthrosis of the big toe. This is a deformation of the joint and pathological changes, as a result of which the hyaline cartilage loses its elasticity and inflammation of the soft tissue occurs. The development of the disease is determined by many factors, the main of which are uncomfortable shoes, excess weight and injuries. Treatment should begin in the early stages, this will provide an opportunity to completely get rid of the disease and avoid the development of the chronic stage of interphalangeal arthrosis of the foot joints.
The myth that the main prerequisites for the occurrence of arthrosis of the big toe is age or salt deposition has long been destroyed. Sometimes these factors can influence the development of the disease, but doctors consider the following to be the main reasons:
The main symptoms that indicate the presence of arthrosis include:
Doctors distinguish three stages of development of arthrosis of the big toe, each with characteristic features and symptoms:
To start treatment, you need to go to an orthopedist, arthrologist or rheumatologist to undergo a study. The following examination methods are widely used:
When the diagnosis is confirmed, a reasonable question arises: how to treat arthrosis, is it possible to carry out therapy at home or is inpatient treatment or sanatoriums used? For this, as a rule, complex methods are used to influence the damaged joint and achieve maximum effect. Methods of treating the disease:
To combat the disease and achieve remission, ointments and medications are used, which, depending on their effect, are conventionally divided into several groups:
Manual therapy helps to straighten a sore joint. Two methods are used in treatment: