Hallux Valgus: What Is It, Surgery, and Life After Surgery

Hallux valgus, commonly known as a bunion, is a condition that typically appears in middle age and is characterized by the inward turning of the big toe. As the big toe turns inward, the metatarsal bone of that toe also rotates outward, resulting in a deformity of the foot. This outward rotation can cause pain in the foot and discomfort inside shoes. In addition to the pain caused by shoes, as the condition progresses, patients may also experience pain and discomfort while walking due to hallux valgus. There may also be swelling and inflammation around the big toe due to fluid accumulation and circulation problems. Inability to properly place weight on the sole of the foot can lead to postural issues and the formation of calluses, resulting in a series of complications.

What Are the Symptoms of Hallux Valgus?

Hallux valgus has distinct symptoms that can differentiate it from many other foot conditions. Therefore, it can be treated with early examination and timely diagnosis before it progresses to advanced stages. These symptoms can be listed as follows:

• Deformity: The inward turning of the big toe begins to alter the structure and shape of the foot. This is the most characteristic symptom of hallux valgus.
• Calluses: Thickening of the skin starts under and around the big toe due to pressure.
• Pain: Pain originating from the big toe spreads to the foot and is felt throughout the body in a painful sensation.
• Redness: Redness becomes more pronounced, especially when wearing narrow and pointed shoes. It causes pain, discomfort, and swelling.
• Restlessness: Due to deformity, calluses, and redness, there may be walking difficulties, discomfort, and a decrease in the quality of life. Restriction of movement leads to restlessness.

What Causes Hallux Valgus?

The most significant identified cause of hallux valgus is its genetic transmission among family members. Although it is commonly seen in individuals who have a habit of wearing narrow and high-heeled shoes, it can also occur in those who wear wide and flat shoes. Additionally, hallux valgus is more common in women than in men. The groups of patients most commonly affected include:

• Individuals with flat feet are at a higher risk of developing hallux valgus.
• Individuals with high arches may also develop a bunion.
• Those with a shortened Achilles tendon are at an increased risk of hallux valgus.
• People with weight problems, resulting in increased pressure on the feet, may experience more significant deformities in the feet and toes.
• Hallux valgus is also more frequently observed in individuals with certain rheumatic problems.
• Anomalies in the hip and knee joints can also lead to bunion deformities.

Hallux Valgus Splint

A hallux valgus splint is a product used to correct the bunion on the big toe. Its adjustability according to the individual’s foot structure and size ensures ease of use. If used during the stages of deformity, it can yield very positive results. Velcro or adhesive splints direct the tip of the big toe toward its proper anatomical position based on the shape of the bunion, thus providing correction. However, regular use is crucial for the splint to be effective. Known as a night splint, the valgus splint is mostly used at night, but increasing its use during the day is also beneficial. It should be used following necessary orthopedic and physical therapy examinations and under the guidance of a physician.

How Is Hallux Valgus Diagnosed?

A physical examination is essential for diagnosing hallux valgus. The specific deformity caused by the condition, as well as the angle and curvature, can be determined through a physician's examination. It is crucial for the patient to stand barefoot, as this allows for a better view of the perspective and anatomical structure. The patient's medical history is also taken, and most patients report increased pain when standing for long periods. These complaints may worsen due to factors such as excess weight and wearing high-heeled shoes. A definitive diagnostic method is the X-ray film. The shape of the bone and joint structure observed in the examined films is the clearest method for diagnosing hallux valgus.

What Are the Treatment Methods for Hallux Valgus?

Various treatment techniques are available for hallux valgus. The choice of treatment method can vary based on the extent, progression, and stage of the condition. The type of treatment is determined by an orthopedic specialist. These treatments can be listed as follows:

• Valgus Splint: Also known as a foot splint, this method is frequently used in the early stages of the condition. It helps the big toe achieve its ideal anatomical structure and shape. Successful results can be obtained with regular use. The process should be monitored by an orthopedic physician, and follow-up appointments should not be neglected.
• Lifestyle Changes: If individuals do not have severe pain, difficulty walking, or an inability to put weight on their foot, small changes can lead to lasting improvements. Avoiding high-heeled shoes and not choosing narrow and constricting footwear can significantly improve the condition in its early stages.
• Physical Activity: Exercises aimed at the big toe are performed to redirect the deformity. Regularly applying these exercises helps bring the bone and joint structure back to an ideal alignment. Moving the toe in the opposite direction also prevents the progression of hallux valgus.
• Silicone Devices: Especially in the early stages of hallux valgus, silicone devices that do not irritate the big toe and reduce the bunion are very beneficial and comfortable. The aim of using silicone devices is to decrease the bunion on the big toe and bring it closer to its ideal alignment.
• Orthotics: Orthotics are generally used in the evenings for hallux valgus. They aim to correct the deformity by applying pressure to the big toe according to the patient's needs. This approach provides a pain-free yet permanent treatment.
• Bone Filing Method: This method is applied to patients who require secondary treatment. Without an extensive surgical procedure, only the bunion on the big toe is addressed. It is applied to individuals whose pain and complaints have reached a level where silicone devices and orthotics are no longer effective. The procedure is limited to filing the bony part where the big toe protrudes, eliminating pain and discomfort when walking or wearing shoes.
• Osteotomy: For individuals with advanced hallux valgus who have little chance of success with first and second-line treatments, surgical treatment is available. The surgery for hallux valgus is called osteotomy. In this method, the bunion that has formed on the foot is removed surgically. The big toe is aligned correctly, and the operation is completed. This also helps prevent the recurrence of hallux valgus.

How Is Hallux Valgus Surgery Performed?

Hallux valgus surgery, also known as osteotomy, is preferred when the bunion on the big toe has reached an irreversible point. The protruding part caused by the outward deviation of the big toe is removed. After that, the bones and joints of the big toe are brought to an ideal anatomical alignment. The surgery may take approximately one hour. Generally, patients are discharged by the next day, but this decision ultimately lies with the orthopedic physician.

Life After Hallux Valgus Surgery

The rest period following hallux valgus surgery is quite important. Generally, patients do not require a cast and can start walking early on with special bandages and shoes, unless the physician advises otherwise. Attention should be paid to issues such as keeping the dressing dry and maintaining hygiene. Antibiotic treatment may be administered under medical supervision to prevent infection. At the end of the process, individuals can walk normally without pain or discomfort from their shoes. Don't hesitate to contact our institution for information on hallux valgus treatment and to schedule personalized treatment plans for your recovery.