The feet bear the body's weight and are subjected to significant weights throughout life. This, along with the fist, is the most complicated organ in the locomotor system. The foot changed and eventually took on its current shape and structure during the evolutionary development of the organs, and as a result was exposed to daily loads. Deformities of the toes - thumb and other toe - are most common in the human foot.
WHAT EXACTLY IS HALLUX VALGUS?
The hallux valgus (Hallux valgus), often known as the hammer on the foot, is one of the most prevalent malformations of the front of the foot, and possibly the most common deformity of the musculoskeletal system of today's man. It is characterized by a sideways distortion of the big toe, a sharpness of the front of the foot, and the formation of a painful bony protrusion on the inside of the big toe's root. Carl Heuter was the first to coin the term "hallux valgus" in 1871, and he was also the first to describe the deformity in detail.
Increased angle between the axis of the first ankle of the big toe and I. foot of the foot (the foot is part of the bony base of the foot made up of five metatarsal bones counting from the big toe), increased angle between I. and II. foot bones, bone growths on the outside of the head I. Foot bones and irritated mucous sac above the bone growth itself with redness of the skin, and in the most severe cases, rotation of the thumb are all symptoms of
Women have a 10:1 chance of having a deformed thumb compared to men. It begins in adolescence and is exacerbated by poor shoe conditions, and it worsens swiftly. The most common illnesses affect people between the ages of 50 and 70, and they frequently affect both sides.
The fourth degree of Hallux Valgus is distinguished as follows:
I have a bachelor's degree (20 degrees) - the start of the hallux valgus
Second grade (30 degrees) - the thumb crosses over the other finger to the third degree (50 degrees) - Thumb in front of or under other finger IV degree (large 50 degrees) - The big toe is positioned above the other toes.
CAUSES
Hallux valgus is most commonly caused by a static deformity, such as a reduced transverse arch of the foot, followed by inflammatory disorders (rheumatoid arthritis, psoriatic arthritis...), trauma, and hereditary or genetic causes. It first emerges during adolescence.
One of the causes of the development of the valgus of the big toe is increased mobility of the first metatarsal bone of the foot, which can be congenital or acquired later in life. Under load, the first metatarsal bone travels away from the other bones and elevates, leaving its position as the front part of the foot's lowest lying bone. As a result of the increasing stress, the anterior arch of the foot, which creates the heads of the metatarsal bones, collapses, the foot expands, and an impression occurs under the second and third metatarsal heads.
The wearing of insufficient footwear is thought to be the source of this disparity (high heels, narrow front of the shoe, etc.). The occurrence of deformation in the Japanese, which first arose when they began to wear conventional Western culture footwear, is the best evidence of how much footwear affects the creation of the distortion itself. The strain on the front of the foot is increased by raising the heel of the shoe, especially in those who stand or walk for long periods of time or who are overweight. The front part of the foot expands like a fan while the longitudinal half of the foot collapses, and the toes in a narrow shoe are less flexible due to the narrow space, so they draw closer and deform.
Foot muscles deteriorate as a result of reduced mobility of the toes and feet as a whole in tight and rigid footwear. Muscle and connective tissue weakness, along with increased and incorrectly directed stress in the foot region, results in further collapse of the front of the foot structure, deformity of the big toe, and the creation of painful growths (lumps) on the inside of the foot. The final development of the distortion and its fast rise is likely due to a combination of factors.
SYMPTOMS
Stretching the tissue of the front part of the foot during activity, as well as aggravating the protrusion at the base of the toe when wearing shoes, causes the pain that sends the patient to the doctor. It's not uncommon to experience recurrent inflammation of the mucous membrane (bursa) on the protrusion (nodule) on the inside of the root of the thumb.
Damage to the cartilage of the articular bodies of the thumb bone and the first metatarsal bone to which the thumb continues can also produce pain. The foot extends as the deformity proceeds, the big toe rotates and goes under the other toes, which gradually develop deformations as well (they bend, underline or cross over each other).
The age of the person affects the severity of the hallux valgus deformity. The deformity is far less common, painless, and the thumb is more flexible in younger people. The deformity is mostly uncomfortable in the elderly, and it is more apparent, with degenerative changes in the thumb's basal joint, the thumb is less flexible, and the deformity is followed by side effects on other fingers.
DIAGNOSIS
Clinical examination, radiographic imaging, and measuring of angles between the bones of the thumb and adjacent sections of the foot are used to determine the degree of valgus in the thumb and, as a result, the type of treatment. The stability of the deformation and its inclination to proceed should be examined based on the joint's position. As a result, the clinical examination is conducted while standing and walking (foot load), as well as when sitting or lying. The degree of deformation, tissue irritation (inflammation of the bursa on the protruding part), mobility or stiffness of the big toe, its position in relation to the surrounding bones of the foot, position and correctness of any other toe deformity, degree of toe sagging, pressure and pain intensity, and the area of their occurrence during the review.
PREVENTION
Mild abnormalities in young people frequently try to slow down their development. Obesity adds to the development of deformities, hence losing weight is recommended. Corrective splints or "separators" for day and night use, which are usually composed of silicone and plastic materials, have mixed effectiveness at best. Wearing wide, comfortable shoes that do not put strain on the toes, shoes with lower heels, and flexible and flexible shoes that stimulate the muscular activity of the tiny muscles of the foot are also recommended. Because this type of preventive and treatment is rarely supported by current design in its usefulness, it is often ineffective when it is most needed - among younger patients. Footwear Dr. Luigi satisfies all of the aforementioned characteristics in the elderly population, which is more willing to give up on fashion trends, and they are a top product and the best choice in health and foot care from a health standpoint. First and foremost, our footwear is comfortable and has soft bottoms to reduce foot movement restriction, which is critical in the prevention of hallux valgus. The fact that the shoes and slippers are made of natural materials with guaranteed safety and the absence of harmful chemical compounds that are commonly used in the process of material processing, dyeing, and footwear production, as well as having antiseptic and antibacterial properties, is perhaps the most important feature.
Dr. Luigi footwear: helps with chronic diseases with static intense load, according to studies undertaken by numerous medical specialists and people who had particular problems with their feet and lower leg (long standing).
exceptionally light and flexible, making it excellent for carrying by people with chronic walking issues as well as medical personnel who are statically burdened.
It contains a tread (sole) that is contoured to the shape of the user's foot, reducing the pain experienced by individuals with vascular illnesses when walking and standing.
The majority of users claimed that wearing shoes helped them walk and stand more easily and that they also functioned as a medical benefit.
TREATMENT
Conservative
There is minimal evidence that conservative treatments are effective in treating hallux valgus deformities, according to hundreds of published research comparing conservative and surgical procedures. Nonetheless, according to the American Academy of Foot and Ankle Surgeons' guidelines, most patients should be treated with conservative therapy first before being referred for surgery. Patients with mild symptoms, according to clinical experience, can gain good symptomatic relief by switching to footwear with a low heel and a wider toe frame. Patients with severe discomfort or dysfunction, as well as those whose symptoms do not improve with non-surgical treatment, should be referred for surgery.
The anatomical and biomechanical aspects of the HV deformity, as well as the intensity of symptoms, will influence the choice of conservative treatment. The following are examples of non-operational measures:
- Wider, more comfortable shoes with low heels have been modified.
- Orthoses (prefabricated or custom-made) are used to enhance foot mechanics in the treatment of hallux valgus abnormalities. Orthoses have been proven to slow the progression of valgus deformity in patients with rheumatoid arthritis.
- Splints - Splints can be used to elevate the toe in the hopes of allowing soft tissue to adjust and postponing rupture of the medial joint capsule and collateral ligament, albeit there is little evidence that such therapies improve long-term outcomes. Night splints are the most popular device, however wedges between the first and second fingers can be worn on a daily basis (finger separator).
- Stretching and/or mobilization / manipulation - Mobilization entails slow repetition of movement within the range of motion, stretching entails applying constant pressure to bring the joint to the end of its range of motion, and manipulation entails rapid movement of the joint outside of its current range.
Physical therapists and other skilled professionals do manipulation and mobilization. They are administered under medical supervision and then maintained at home by the patient through additional stretching and special exercises.
- Silicone pads - Anti-friction medial pads can help reduce skin irritation.
- Ice - To relieve inflammation, apply ice to the area as needed after activity (15 to 20 minutes; do not apply directly to the skin to avoid skin damage).
- Analgesics - Systemic analgesics can be administered after physical exercise or when pain persists despite rest or topical cooling application.
Operationally
Surgical repairs of thumb deformities that do not cause more acute pain are only indicated for aesthetic reasons. The goal of surgical treatment for big toe valgus is to rectify the big toe's posture, remove the painful protrusion from the interior of the big toe, and balance the soft tissues of the foot. As a result, the thumb should develop a flexible, robust basal joint that can carry the strain and execute its role while standing and walking. Treatments on the soft tissue of the foot, the first metatarsal bone, the bone of the thumb, or a combination of these procedures can be performed depending on the degree of deformity, the patient's age, and the condition of the basal joint of the thumb.
In certain cases, milder degrees of thumb valgus deformity can be treated using minimally invasive treatments, in which the bone is corrected and incision is made through a small orifice in the skin under radiological control. Wires, screws, plates, and other devices are used to fix the bones in the precise place. Bone strengthening is required to keep the deformation correction in the right position, therefore it precludes the use of alternative less comfortable immobilization techniques (plaster).
Only when the bone is totally healed is it possible to fully load the feet when standing and walking. Within 3 to 4 months of surgery, you should be able to resume all activities and wear normal footwear. Although wearing trendy shoes with a pointed toe and a high heel is not suggested, it is possible after a successful treatment, with the caveat that wearing such footwear risks recurrence of distortion. Orthopedic insoles are used to help maintain the feet's reduced anatomical arches. Exercises to strengthen the muscles of the foot must also be performed on a regular basis, as directed by an orthopedist.
HALLUX VALGUS EXERCISES
General activity, as well as particular exercises to strengthen the foot muscles and stretching, are all encouraged, although all activities should be limited by pain. Two 20-40 minute walks are beneficial to the entire body and inflamed muscles. Exercises should be done without wearing shoes. They influence the little muscles of the foot and toes, as well as the major groupings of muscles in the lower thigh and higher leg that support the arches of our feet. It would be acceptable if the exercises were done multiple times per day.
- Actively expand the big toe from the other toes is the most crucial exercise at the start of hallux valgus. In a sitting position, you can accomplish this. If you have adequate control and mobility in your toes, you can just try moving the toe as far away from the other toes as possible numerous times. The toe should not be twisted or pushed out in front of the other toes, but should be level with them.
- After you've tried spreading your fingers without using your hands, try separating only your thumb from the base of your thumb in a standing position. If that doesn't work, use your hand to grip the other fingers and workout that way until the muscle becomes stronger.
- Then, with the exception of your thumb, press your thumb into the base and try to move all of your other fingers. Then try raising and lowering one finger at a time. Raise your thumb and keep it there, then join the next digit and so on until you reach your little finger. So go in a different route. You lower your little finger, then raise it, and so on until you reach your thumb. The foot should not swing from left to right while performing these exercises.
CONCLUSION
Will the deformity return? This is a common concern among patients. The answer is determined by the degree of deformation corrected, the type of surgery performed, and the degree of correction achieved after rehabilitation. The patient's post-operative behavior, as well as the type of footwear he or she chooses, are critical. Narrow shoes with high heels are not advised; instead, pleasant, soft, and wider footwear with a specially tailored orthopedic insole, such as Dr. Luigi medical footwear, is recommended. Because the patient's personal, genetic history and the structure of his own tissue have a role in the development of hallux valgus, secondary prevention - postoperative measures - can help prevent the deformity from recurring.