Hallux valgus or bunion: what is it and how can it be corrected

The hallux valgus or bunion is an imperfection of the first toe called hallux, and is characterized by presenting an outward deviation. This mass that can be seen on the inner edge of the foot is called a bunion.

This foot pathology is one of the most frequent and can be mild, moderate or severe. People with this deformity generally do not see a specialist doctor unless they are in pain. Bunions appear mainly in women due to the use of inappropriate footwear. The initial treatment is to wear a comfortable shoe, and if the discomfort continues, surgery is required.

Next, you will obtain relevant information on this subject, from its definition to its treatment and the appropriate ways to correct this imperfection.

What is a hallux valgus or bunion?

The hallux valgus or bunion, also called bunion, is a deviation of the big toe. It is characterized by a bulge and improper angle of the head of the first metatarsal bone.

Also, it can occur on the other toes. But its appearance on the first finger is more frequent.. It causes an inflammation that causes pain on the edge of the foot. It tends to appear more frequently in women, due to the use of inappropriate footwear. Another cause of appearance may be due to a family history.

Why does hallux valgus or bunion originate?

The hallux valgus or bunion is caused mainly by genetic predisposition. Therefore, it is necessary to determine what type of foot we have. According to the length of the toes there are three types of foot and they are:

Egyptian foot

Where the first finger is greater than the second, and this greater than the third, so on. It is the most common type of foot.

Greek foot

The first finger is shorter than the second. But this is greater than the third, and so on.

Square foot

The first toe is about the same length as the second. The rest are progressively decreasing in length. It is the least frequent type of foot in the population.

The Greek foot is the one with a low incidence of disorders. On the contrary, people with Egyptian-type foot are the most prone to suffer from various pathologies, especially hallux valgus and rigid hallux.

Probable causes

In general, the main causes are the following:

• Use of inappropriate footwear, that is, with a pointed toe or that do not fit correctly.
• For a defect in the tread.
• Foot injuries.
• Certain types of arthritis (rheumatoid arthritis).
• Family background.

What are the symptoms of hallux valgus?

The most common symptoms that occur in people with hallux valgus or bunion are:

• Persistent pain
• Swelling in the area where the toe meets the rest of the foot.
• A deformation in the finger can be seen with the naked eye.
• Rubbing sensation in the affected area.
• Cracking when moving the finger.

How are hallux valgus or bunion diagnosed?

To make a diagnosis of this pathology, the specialist, who for these cases must be a podiatrist or a traumatologist, must make a physical evaluation of the patient and an interview to fill out the clinical history. Likewise, you must specify if there is a family history, as well as a description of the symptoms presented.

In the event that a surgical intervention is required, the specialist should request an X-ray. In such a way, that through this study, determine the abnormal angle between the foot and the big toe.

Treatment to follow

The treatment to be followed for this affectation at the pharmacological level is through anti-inflammatory and analgesic medications.

Patients are also relieved by performing the following techniques:

• Application of heat and cold.
• Avoiding movements that accentuate the pain.
• Physiotherapy.
• Using suitable footwear, with a soft texture, a wide last and that does not produce rubbing on the bunion.
• Placement of orthopedic pads.
• Treat associated conditions such as valgus flat feet or metatarsal overloads.

If, when trying these techniques, there is no improvement, a local infiltration can be performed to alleviate the discomfort. Now, if what you want is a definitive solution, you must resort to surgery.

Currently the most used method in a surgical intervention is the metatarsal osteotomy distal in inverted V. It consists of sectioning the metatarsal head. In some cases, it is not possible to make a definitive correction of the deformity. Therefore, the bunion can reappear if the post-operative indications of the specialist are not followed. The risks that can occur in this surgery are low.

There are other proximal metatarsal osteotomies, called the base procedure, Scarf, Lapidus, among others. Which are usually done in the case of more advanced deformities.

For patients who, in addition to hallux valgus, have osteoarthritis in the big toe joint, an osteotomy is not performed. The surgical technique applied consists of a joint fusion (arthrodesis) or a part of the joint is removed (arthroplasty). Thus, this procedure is an excellent alternative because it corrects the deformity, represses the return of the bunion and eliminates osteoarthritis.

Recovery after surgery for hallux valgus

Peripheral nerve blocks are used in all surgeries for this condition. In addition, a standard treatment with analgesics, despite being classified as a painful surgery, by means of these methods, pain is no longer a problem for patients who undergo these procedures.

The main disadvantage that patients undergoing surgery of this type find is the swelling of the limb. Therefore, rest with the limb raised and the use of compression stockings is essential.

The return to the daily routine of the patient will depend on the type of activities that he performs. So the rest time is variable.

Prevention measures to consider to avoid hallux valgus

The main preventive measure that can help us avoid bunion is to have a proper footprint when walking. Also, use correct footwear such as wide-toed shoes, which are not narrow-toed and do not rub against any part of the foot.