Hallux valgus is a common problem, consisting in progressive abduction and rotation of the great toe, with development of an exostosis at its base. It is a complex deformity of the foot, usually accompanied by deformities of the rest of the toes.
CAUSES – PATHOPHYSIOLOGY
The cause of Hallux valgus is multifactorial. The main cause is the anatomical formation of the foot, which predisposes to this deformity. Inappropriate footwear, narrow shoes with a high heel do not cause deformity, but contribute to its aggravation, that is why this condition is more common in women. Heredity factors and rheumatic diseases also play an important role. Apart from deformity of the foot, this condition causes pain and difficulty walking.
The treatment of Hallux valgus in the early stages is, like that of other orthopaedic conditions, non-surgical. That is, wider shoes, soles and other orthopaedic aids are initially proposed. When, however, a serious deformity develops and there is no improvement in the complaints in any other way, then we resort to surgical treatment.
The choice of technique – whether it will be a classic approach or a minimally invasive technique, as well as the type of osteotomy depend on the degree of deformity of the foot, as well as on the existence of concurrent conditions.
The modern surgical correction of Hallux valgus is performed with a minimally invasive technique, usually under regional anaesthesia. Special fine instruments are inserted through incisions of 2-3 cm in length, to perform x-ray controlled corrective osteotomies and exostosis removal. In addition to the great toe, existing deformities of other toes are also corrected. The osteotomies are kept in place with special screws made of titanium, which need not be removed later on. The patient can start walking immediately with the special postoperative shoe, without crutches and is released from hospital on the same day. With this method there is less injury to the soft tissues, so that recovery is faster, with minimal postoperative pain.
The technique can be used in the great majority of cases, with the possible exception of some extreme deformities.