The Bump on Your Big Toe
The protrusion on your big toe not only negatively affects your aesthetic appearance but also your health.
Pointed toe and high heels may trigger your discomfort.
Hallux valgus;
It is a disease that affects the joint between the first toe and the first metatarsal bone. This swelling and protrusion in the joint is called “bunion”. In fact, this condition is the painful protrusion and deformity that occurs in the big toe, which is mostly seen in women and negatively affects social life. This deformity actually has a more complex structure than the swelling and protrusion. This disease is not encountered in cultures that do not wear shoes. While % is seen in 40 percent in women, there is a high genetic predisposition of % at 70 percent. It is more common in women who have been wearing high-heeled and pointed-toed shoes for many years. Wide shoes that provide plenty of space for the toes reduce the chance of this deformity developing, and if a bunion has developed, it also helps to reduce the discomfort caused by it.
Hallux valgus may present with pain and swelling.
Hallux; is the medical term used for the first toe and valgus is an anatomical term that indicates that the deformity is directed outward from the midline. Therefore, hallux valgus; is an orthopedic disorder in which the big toe is directed towards the outer side of the foot. If this deformity gets worse; secondary changes that increase the problem in the foot occur. First, irritation, redness and swelling develop. Over time, the tissue here thickens and a larger protrusion forms, causing the shoe to rub. The cause of many problems in the foot is abnormal pressure and friction. Over time, complaints arise due to the skin and soft tissue being caught between the hard bone inside and the hard shoe outside. Any protrusion in the bone worsens the situation. The skin responds to constant pressure and friction by forming a “callus tissue”. The soft tissue underneath responds by thickening. These structures cause irritation and pain in the patient. In order to reduce this pain, it is necessary to reduce the pressure. This is possible by reducing the pressure created by the shoe from the outside or by surgically removing the bony protrusion inside. Complaints related to hallux valgus are usually on the protrusion called bunion. Bunion is painful. Serious hallux valgus deformity also causes cosmetic problems. Especially female patients have difficulty finding shoes that fit their feet. As the deformity increases, the second toe lifts upwards and is exposed to pressure and friction inside the shoe, causing pain in patients.
Definitely see an orthopedic specialist.
The diagnosis is made after a careful, detailed history and clinical examination. Information is obtained about the patient's shoe choices. Foot X-rays are taken. The angles between the bones are measured by your doctor, which helps determine the treatment method with X-rays. Hallux valgus treatment begins with the selection and wearing of shoes that are suitable for the foot. In the early stages of the disease, replacing pointed shoes with wide-toed shoes can reduce the patient's complaints. Wide shoes are useful in reducing the pressure on the bunion and reducing pain. In addition, bunion pads and toe rollers can be used to reduce pressure and pain.
Definitive results can be achieved with surgical methods.
If all nonsurgical methods fail to relieve the patient's pain or if the disease is diagnosed at an advanced stage, surgical treatment options are considered. More than 100 methods have been described in hallux valgus surgery.
If we count the basic principles;
– Bunionectomy (Removal of the bunion):If hallux valgus is in the early stages, only bunion removal may be effective. With the incision made over the bunion, the underlying protruding bone tissue is cut with appropriate orthopedic material. The bone surface is shaved.
– Metatarsal Osteotomy (Bone correction): Usually, bunionectomy alone is not sufficient to correct the deformity in hallux valgus surgery. Metatarsal osteotomy (correction of the metatarsal bone with incisions) surgeries may be necessary. An incision is made in the bone; the angle that creates the deformity in the bone and joint is corrected. Patients are followed up with a bandage or plaster treatment after the surgery. The patient is made to stand up with crutches on the first day after the surgery and walks. They are not allowed to step on the operated foot. The stitches are removed on the 15th day of the surgery. Control radiographs are taken. If there is union in the bone in 6 weeks, the metal pins are removed and the patient is allowed to step. This healing process of approximately 6 weeks should be considered a minor problem compared to the negative effects of the disease on your social life and your major complaints such as constant pain.
