A hallux valgus is a bunion that occurs on the big toe. Hallux means big toe and valgus means deviation away from the body. Many things contribute to a bunion’s occurrence. The type of shoes you wear, if they are ill fitting, may contribute, but a bigger factor may lie in hereditary problems with bunions. You are more likely to develop bunions if your family members have also been afflicted with them.
The most common place for bunion pain to appear is the inner border of the big toe, as this is the largest point of the toe, where the maximum point of pressure is. There may also be pain in the second toe. The second toe has to work harder, as the big toe becomes deformed and less useful in the walking process. Pain will often be aggravated by walking in close-toed shoes. You may feel less pain in sandals or open-toed shoes, and it is unusual to feel any pain when there is no weight on the toe.
Treatment for a hallux valgus can be either non-operative or, less often, operative. Non-operative treatment includes wearing wider shoes or sandals. You can also fit silicon spacers between the toes to alleviate pain when walking. These options will not cure a hallux valgus, but will help make the pain more tolerable.
The decision to have surgery is usually made on the basis of how much pain one experiences due to the hallux valgus. There are many different operations available to treat the bunion, and each depends on the degree of deformity. A common operation to treat the hallux valgus is called a chevron osteotomy. This involves a V shaped bone cut in the metatarsal. Once the cut in the metatarsal is made, the bone is shifted over and the remaining edge of the bone is shaved down.
Another popular osteotomy is the Myerson/Ludloff procedure. This operation is performed on more severe cases of hallux valgus. Screws are inserted into the metatarsal to hold the bone cut securely and to speed up bone healing. You will be able to walk in surgical shoes following the procedure. The shoes must be worn for approximately five weeks.
For people with arthritis of the big toe associated with hallux valgus, an osteotomy will not be performed. The deformity will need to be corrected through the joint, either with a fusion or by removing a portion of the joint. This procedure is known as an atrhroplasty. Fusion of the big toes corrects the deformity and prevents the hallux valgus from returning. The fusion also eliminates the arthritis.
