What Are the Symptoms of Hallux Valgus Deformity?

Hallux, commonly referred to as a bunion, is a degenerative foot condition affecting the first metatarsophalangeal joint. This deformity, primarily observed in women, leads to pain and impaired mobility. Lifestyle factors significantly contribute to its development. Image: VITALOGY.

Despite incomplete understanding of the causes of hallucinations, medical professionals highlight several factors that may contribute to their development. Most frequently mentioned are various genetic factors and mutations that increase the likelihood of developing a bunion. Examples include the inheritance of traits such as excessive connective tissue laxity, the Egyptian foot shape (where the big toe is longer than the second toe), or an irregular structure of the metatarsophalangeal joint. Additional risk factors include obesity, longitudinal flatfoot, poor foot hygiene, congenital bone deformities, and bone mineralization disorders. Improper footwear, particularly high-heeled shoes, also contributes to forefoot overloading. Shoes with pointed toes further increase pressure on the big toe and the transverse arch of the foot, potentially leading to transverse flatfoot and toe deformities. These conditions disrupt normal foot function, resulting in uneven weight distribution and muscle imbalances. All these factors create favorable conditions for the development of bunions.

The clinical manifestations of hallux valgus are highly visible and cause discomfort, yet patients frequently delay medical consultations. By the time they seek specialist care, the condition is often in an advanced stage, complicating treatment. Prompt intervention is crucial when the pathology is in its early phase. Common symptoms include: – a noticeable protrusion on the outer aspect of the metatarsophalangeal joint of the big toe, accompanied by its deviation toward the other toes; – pathological thickening in the affected area, along with redness and tenderness upon touch; – pain in the base of the big toe and midfoot region, worsening during ambulation; – resting pain in the protruded area of the foot, occurring even at night; – transverse flatfoot as a consequence of progressive hallux valgus.

As previously mentioned, individuals with hallux valgus often delay seeking medical attention. This is due to the tendency to overlook symptoms and postpone specialist consultations. Therefore, it is advisable to recognize early signs to avoid a prolonged and challenging treatment process. Hallux valgus treatment can be categorized into two approaches: conservative and surgical. Conservative therapy involves self-management through simple techniques. These methods are applied when the deformity does not cause severe pain that impairs daily functioning. They include: – protective pads and gels to shield painful areas; – corrective devices used during the day and night; – pelotes to prevent flatfoot development and slow the progression of the deformity; – hallux valgus splints that maintain proper toe alignment and distribute pressure evenly across the foot; – wedges and separators to reduce friction and restore proper toe positioning; – silicone inserts, primarily designed for women with transverse flatfoot and hallux valgus. Surgical treatment is indicated in advanced cases or when pain and inflammation significantly impair the patient's quality of life. Common surgical procedures include Chevron distal osteotomy (realigning the first metatarsal head in mild to moderate deformities), Scarf diaphyseal osteotomy (offering stable multiplanar correction allowing early postoperative mobilization), the Lapidus tarsometatarsal arthrodesis, and soft-tissue tendon balancing procedures designed to restore physiological gait biomechanics.

Chevron osteotomy involves a surgical procedure where the bone is carefully cut at the junction between the toe and the metatarsal bone.

The Scarf technique is an osteotomy procedure involving a Z-shaped incision of the first metatarsal bone. This approach ensures effective stabilization of bone fragments and allows for relatively early weight-bearing on the affected foot. Patients can begin walking in postoperative shoes as early as 2–3 days post-surgery, and after approximately six weeks, they can transition to standard footwear.