Symptoms can vary from person to person: some patients complain of pain in the second toe rather than the big toe, while others report experiencing violent pain, even without having notable deformities. The most common symptoms are:
- Pain at the base of the big toe where a bony protrusion (exostosis) is formed on the internal side, surmounted by a bursitis, increasingly inflamed and red;
- The big toe gradually tilts laterally towards the toes, causing a secondary axial deviation;
- With the worsening of the disease, the big toe may even be located under the second toe which, at this point, dislocates itself on the metatarsophalangeal joint, until it is raised and hyperextended;
- Persistent pain in the big toe area, swelling and redness that worsens over time if the disease is not treated properly;
- Formation of painful calluses on the sole of the foot, due to excessive plantar protrusion of the metatarsals;
The causes of the onset of hallux valgus are essentially of two types.
In primitive hallux valgus they are genetic and constitutional. This pathology develops over the years, often tracing a defect already present in the same family.
In secondary hallux valgus, this deformity can be caused by acquired causes, such as autoimmune diseases (e.g. rheumatoid arthritis) and degenerative diseases (e.g. postmenopausal pronated foot).
Additional causes can be:
- congenital malformations;
- use of unsuitable footwear (narrow sole, narrow toe and high heel);
- foot injuries;
- problems with weight, posture or muscle tone;
- some types of arthritis;
Some measures can be adopted to alleviate the symptoms affecting the foot, which are however not able to cure the deformity:
- Avoid activities that force you to stand for long periods of time;
- Use appropriate footwear: the best shoe to wear takes up the natural shape of the arch. The heel should not exceed 4-5 cm., Because excessively high heels force the foot to an unnatural position;
- Insoles: they allow to avoid an overload of the front part of the foot and help to minimize painful symptoms;
- Physiotherapy treatments to reduce symptoms and relieve pain;
- Medicines: they can be indicated to reduce pain and inflammation.
If symptoms are severe and alternative treatments are not effective, surgical treatment is the solution.
In these cases, in fact, the surgical intervention must be aimed at treating joint damage with traditional arthroplasty techniques with or without implantation of prosthetic material, atrodesis, etc., by which the correction of valgus is a secondary consequence.
The percutaneous technique
The percutaneous technique is characterized by the use of small burs similar to those used in the dental field for modeling and sectioning (cutting) the bones, introduced through the skin and in contact with the bone, through tiny holes without the need for surgical incisions.
The different typology of these drills allows the execution of different surgical gestures (milling of the exostoses, section – osteotomy of the metatarsals or phalanges), often not dissimilar to those performed in an invasive way in traditional surgery.
The correctness of the sections (cuts) or of the modeling of the bones is checked during the operation through the use of the intra-operative fluoroscope, so that the image of the operating field is always visible on the monitor by means of scopy (use of x-rays) .
In this way, a foot “soft” is obtained thanks to manual correction, by moving the small fractures practiced and then left free, the final correction is ensured by a particular containment bandage that in no way must be removed, except by specialized personnel.
All with the assistance of your Personal Health Planner
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