Hallux valgus - the most common toe deformity in foot care
"Hallux valgus" is by far the most common toe deformity in humans. It is characterized by the outward deviation of the big toe at the metatarsophalangeal joint with simultaneous internal rotation. In addition to hereditary factors, shoe fashion plays a particularly important role in the development of this toe deformity, which is why women are much more frequently affected than men. Tight footwear leads to mechanical irritation, constantly pushing the big toe outwards. Due to the change in the direction of pull of the muscles, the deformity continuously worsens. The connection with a splayfoot static is of essential importance, with both conditions reinforcing each other.
Basically, the typical development takes place over several years, which is why the frequency of the disease increases sharply with age. In the beginning, the cosmetic change is most noticeable; there are no complaints yet. The first noticeable pain usually occurs on the inside of the first metatarsal bone; in this context, exostosis is often mentioned. Due to mechanical irritation, painful irritations of the skin and the developing bursa occur at this widest part of the foot, which can be accompanied by inflammation. Over time, the misalignment of the big toe leads to hallux rigidus (wear and tear and restricted movement of the metatarsophalangeal joint of the big toe).
A clinical finding is necessary for diagnosis, with the extent of the splayfoot static and the osteoarthritis of the metatarsophalangeal joint of the big toe needing to be determined by an X-ray. As for possible treatment approaches, conservative treatment (only useful in milder cases) includes open or sufficiently wide shoes, ring-shaped foam pads, or silicone pads. For inflammatory skin changes, local measures such as moist compresses and ointment dressings or ice application can be useful for reducing inflammation. The use of so-called hallux valgus splints is recommended primarily in the early stages or when surgical treatment is not possible. The frequently asked question of whether an operation is advisable or not must be decided on a case-by-case basis. In principle, it can be stated that for purely cosmetic reasons, restraint is more appropriate, while for treatment-resistant complaints and largely exhausted foot care options, surgery is usually advisable. The appropriate surgical method also depends on the individual clinical picture: a total of more than one hundred different surgical techniques underscore that there is no "ideal" method.
