HALLUX VALGUS

Surgical interventions and techniques:

There are many surgical techniques for the correction of hallux valgus. Some operations are performed by “conventional” technique with scars of a few centimeters and others are performed by “minimally invasive” or “percutaneous” technique with scars of a few millimeters. The different surgical procedures are identical regardless of the technique used with removal of the bony "bump", section of ligaments and section of the bone (osteotomy) of the metatarsal and phalanx to align the big toe. Some techniques require the placement of hardware (pins, screws, staples, plates) to maintain the desired correction. The operating technique used (conventional or percutaneous), the procedures performed and the placement or not of equipment depend on the extent of the deformation, the findings (during the consultation and during the intervention) and the surgeon's habits. .

Operative suites:

The resumption of full support, normal footwear, driving and sports activities will be decided by the surgeon. It is normal to have edema of the forefoot for about 3 months after the procedure. This edema is linked to the importance of the actions carried out, the existence of venous insufficiency and daily activity. The onset of edema should be avoided during the day, a source of prolonged pain, stiffness, delay in resuming activities and normal footwear. Dressings with cohesive bands or compression socks are necessary to actively combat edema.

Frequently asked Questions:

Is this deformation due to the footwear or is it hereditary?

There are forms of congenital hallux valgus (deformity from childhood and adolescence) and forms acquired in adulthood. All these forms are of variable evolution according to each patient. The fit and heredity probably have a part of the responsibility that is very difficult to assess. Not putting on certain types of shoes may not prevent hallux valgus from developing. Nor is it because a member of our family has a hallux valgus that we will automatically inherit the same deformity.

Should the operation be done before the deformation worsens?

NO: The surgical intervention is not decided according to the importance of the deformation but according to the daily discomfort and the difficulties to put on. A painless deformity does not justify surgical intervention. The patient is the only person who can know if the discomfort is becoming more and more important and difficult to tolerate and can decide whether to have the operation. The surgeon will decide on the most suitable operating technique depending on the examination during the consultation, the importance of the deformation, the analysis of the X-rays and his habits.

Are there other treatments for hallux valgus besides surgery?

In adults, only surgery can correct the deformities to make the symptoms disappear. There are alternatives to surgery such as protective orthotics, adaptation of the footwear, infiltrations which can reduce certain symptoms or make certain painful outbreaks go through but which do not correct the deformation. In children before the end of growth, nightly corrective orthoses can be used to slow down the progression and reduce or even correct deformities.

Is there an age limit for operating a hallux valgus?

NO: If there is any indication for an intervention for a hallux valgus, it can be performed at any age. In children or adolescents, the aim of the intervention is to correct the deformities and allow a rapid return to activities. In the elderly, the aim of the intervention is to allow an immediate resumption of walking with improved comfort when putting on footwear while avoiding immobilization.

What are the possible complications of a hallux valgus procedure?

Like any surgical intervention, there can be general complications (heart problems, pulmonary embolism, allergies, etc.) and local complications (phlebitis, infection, necrosis, amputation) most often linked to pre-existing health problems (heart problems, blood disorders). coagulation, arteritis, diabetes, etc.).

• There are more specific complications of hallux valgus surgery such as recurrence of the deformity, overcorrection, stiffness of the big toe joint, residual pain, sensitivity disorders of the toes, algodystrophy. ...
• All these complications are rare but can occur and it is thanks to the discussion with the surgeon and the anesthesiologist in consultation before the operation that the risk of complications can be evaluated to reduce it as much as possible.

How do you decide whether or not to have a hallux valgus operation?

If the discomfort (when putting on shoes, walking, in everyday life) is less and less tolerable or is no longer tolerable: the surgical intervention will make it possible to obtain an improvement.

• If there are painful outbreaks (seasonal, intermittent) and periods without any discomfort: the intervention may be necessary in case of worsening but it is sometimes necessary to know how to wait and not to have an operation from the first painful outbreak because some inflammatory attacks can disappear spontaneously.
• If the discomfort is mainly aesthetic: the operation is not recommended because the risk associated with the operation is greater than the expected benefit.

Are there other treatments for hallux valgus besides surgery?

In adults, only surgery can correct the deformities to make the symptoms disappear. There are alternatives to surgery such as protective orthotics, adaptation of the footwear, infiltrations which can reduce certain symptoms or make certain painful outbreaks go through but which do not correct the deformation. In children before the end of growth, nightly corrective orthoses can be used to slow down the progression and reduce or even correct deformities.

Is there an age limit for operating a hallux valgus?

NO: If there is any indication for an intervention for a hallux valgus, it can be performed at any age. In children or adolescents, the aim of the intervention is to correct the deformities and allow a rapid return to activities. In the elderly, the aim of the intervention is to allow an immediate resumption of walking with improved comfort when putting on footwear while avoiding immobilization.