What is hallux valgus?
Hallux valgus, also known as a bunion, is the most common misalignment of the big toes. It is a deformity in which the big toe deviates toward the small toes. In a severe type of deformity, the big toe goes below or above the second toe.
In a hallux valgus deformity, the joint connecting the bones of the foot and toe (metatarsophalangeal joint) are overextended, and as a result, painful arthritis of the big toe (hallux rigidus) can develop.
The protruding bunion at the metatarsophalangeal joint becomes inflamed and painful.
When does hallux valgus require a surgery?
Surgery is required in the following cases to:
- Improve cosmetic appearance
- Correct painful misalignment
- Correct mobility restricting a bunion
- Correct the deformity before it worsens
- Overcome failure of the conservative measures to relieve symptoms
When should be a hallux valgus osteotomy avoided?
A hallux valgus osteotomy should be avoided in patients with
How is a hallux valgus osteotomy performed?
Before the surgery:
- The patient will be given painkillers on the day of the surgery.
- The physician will choose and give a local or general anesthetic to the patient.
- The physician will place triangular support under the patient’s knee to keep their foot flat on the table.
- The physician will place the patient’s foot over a bump of double-brick height and shape to clear it from the other foot.
During the surgery:
The procedure depends upon the type of osteotomy selected by the physician. The most commonly performed osteotomies are described further below:
- Chevron osteotomy: A V-shaped wedge is removed from the part of the big toe with the joint—also known as the metatarsal head. An incision is made at the back of the foot. This technique is useful for moderate hallux misalignments. The metatarsal head is aligned to the default position and secured with titanium screws.
- Scarf osteotomy: During the procedure, a Z-shaped wedge is sawed out at the side of the big toe. The metatarsal head is aligned to the default position and secured with titanium screws.
- Akin osteotomy: In this technique, a wedge-shaped wafer of the bone is sawed out at the side of the big toe.
The wound is irrigated and closed with stitches.
After the surgery:
- The patient should elevate their foot and place ice packs on the foot to minimize pain and swelling.
- The foot will be covered in a special bandage. The stitches will be removed after about 12 days. The patient will have to wear special shoes for four weeks, which takes the pressure off the forefoot.
- It takes about three to six weeks for complete healing. Post-procedure infection may be observed with this surgery.
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