What is Hallux Valgus?

Hallux valgus, or bunion, is a deformity of the "big toe" of the foot and the metatarsal in particular, the long bone above the phalanges, the bones that form the skeleton of the toes. The onset of the disorder is insidious, because it is characterized by intense pain, which can fade and then reappear later, but the deformity of the finger is manifested only in an advanced stage of disease.

How and 'made the foot?

The skeleton of the foot is composed of 26 bones arranged in three groups that, proceeding from the leg, make up the skeleton of the tarsus (the rear part of the foot), of the metatarsus (the central part of the foot) and of the fingers or phalanges (the front part of the foot).

As is becoming apparent hallux valgus?

The big toe is manifested at the beginning in the form of a small ledge around the head of 1 ° metatarsal around which appears an inflamed area, especially after a long rubbing against the shoe called bursitis.

How does it occur?

Hallux valgus is then an anomaly hallux, which is precisely valgus, towards the outside and with the tip pointing towards the other fingers. Usually is also accompanied by a deformation of the 1° metatarsus which is protruding and launching, ie deformed towards the inside. In particular, we speak of hallux valgus when the angle between the first and second metatarsal, corresponding precisely to the first and second finger, is more than 8%. This can be evaluated by a simple X-ray only be carried out with the foot under load.

Hallux valgus may be congenital or acquired?

Hallux valgus may be either congenital or acquired. And 'congenital, when due to the fact that the metatarsal head, (the last part of the metatarsus that articulates with the base of the phalanx) is round or no additional other factors, such as those family members, or linked to the anatomy same of the foot. The main causes of a bunion acquisito are: uncomfortable shoes, such as tight shoes with high heels, is a major cause of hallux valgus acquired, why more than 90% of those affected are women, the Egyptian foot, which has when the big toe is longer than the other fingers; susceptibility.

The shoes that play role in the onset of hallux valgus?

One must be very careful with the shoes you wear, in fact the use of footwear is wrong among the most frequent worsening of hallux valgus. In particular, those to narrow tip cause excessive pressure on the fingers, that ago to move both the big toe is the little finger towards the inner part of the foot, in this way, the other fingers are crushed. These pressures increase even more when the shoes have high heels, because all the weight of the body moves automatically to the front of the foot. Even the use of shoes very rigid may prevent the natural flexion of the fingers when walking, because the musculature of the foot weakens, facilitating the appearance of alterations.

What causes problems?

In general, at the beginning of the disorder the pain is due both to inflammation of the tissues that cover the protrusion and that are located below it as also the subluxation of the articulation of the first finger, as a consequence of the deviation.

But with time can arise other disturbances?

The new position of the joint forces the person to walk incorrectly, with the risk of taking wrong positions in an attempt not to feel the pain. Occupying space in the shoes, also, the bony protrusion imposes the use of comfortable footwear, if not even made to measure, to avoid that the other fingers from overlapping between them. In addition, the entire spine is affected by the new situation. The speed with which the disease gets worse depends on natural ability, the type of life we lead and the shoes you wear.

How to prevent?

To prevent hallux valgus must first pay attention to shoes that are used, then, to prevent other foot ailments, you should check them often and take care of it. And 'advisable to use comfortable shoes, soft leather and with a wide tip, with a heel that does not exceed 4 cm.

How to solve the problem?

There are treatment systems conservative and treatment systems more challenging as the surgery.

How to surgically correct the "onion"?

More than 100 surgical techniques used to correct the hallux valgus. It is not just a cosmetic deformity but a common and painful disorder that primarily affects women. All orthopedic rightly argue that the hallux valgus is to be made only if its presence can affect quality of life and not just an aesthetic defect. All the techniques are still painful in the postoperative phase, and never completely without risk of complications.

What to do after surgery?

After the operation the patient must adhere to certain standards recommended by the doctor depending on the type of intervention.

I have friends who have undergone this surgery and whose deformity is manifested again?

In all the techniques they used plastic soft tissue for the correction, recurrence was very common. Current techniques are based on geometric correction of the deformity and is' therefore difficult but not impossible that it can occur again if the technique is performed correctly.

It's true that the intervention is painful?

It takes a series of adroitness to avoid the post-operative pain: for first thing must not be used the fascia ischemic during the intervention, since the arrest of blood flow causes pain alive at the end of anesthesia and does not allow haemostasis accurate. And 'then fundamental the use of an anesthetic to long duration of action and the choice of an appropriate analgesic administered promptly before the end of anesthesia. Following these attentions pain is reduced to an oppressive feeling of discomfort during the first night and the next day.

Is physiotherapy needed after surgery?

And not 'necessary because the ambulation mobilizes automatically the articulation.

It's better to operate one foot at a time or both together?

Always one foot at a time.

How soon can you return to driving ?

A week later, on occasions, we feel ready to do it.

What shoes can I wear after surgery?

Non vi e' alcuna limitazione all'uso di scarpe, anche se con tacco e a punta stretta, purché non siano l'unico tipo ad essere indossato. Alternare diversi tipi di calzatura e' infatti la migliore "ginnastica" per i nostri piedi.

What time of year, and 'should have the surgery?

Each period has its advantages. During the first winter, the edema is reduced because of the cold, and the convalescent home 'easily bearable. In spring and early summer months you can wear open shoes, and you can perform the functional recovery of the sea, walking on the shore and swimming. Personally I would not recommend a season, but a period in which the patient enjoys a quiet work, family and staff, to deal with no worries convalescence