Hallux valgus, also commonly termed as bunion, is characterized as the static subluxation of the 1st metatarsophalangeal joint described as lateral (outward) deviation +/- rotation of the first toe and medial (inward) deviation of the first metatarsal. It is not a single deformity but rather a complex deformity of the first ray. This condition is one of the most common foot problems in the adult population, with a prevalence of around 35% in those aged >65 years and more common in women. Diagnosis is mainly clinical and investigation using plain weight-bearing radiographs of the foot usually suffice. Clinical features include pain over the medial eminence exacerbated by walking, weight bearing, and wearing narrow toed shoes, pain on the lesser toes (metatarsalgia), plantar keratosis beneath lesser metatarsal heads and callosity on the medial side of the 1st metatarsophalangeal joint. Symptoms have often been present for some time before presentation. However, have worsened in frequency and intensity. Causes range from extrinsic (shoes with high heels and narrow toe boxes, one size smaller shoe) and intrinsic risk factors (female gender, genetic predisposition, ligamentous laxity, pes planus).
Treatment typically consists initially of conservative measures such as shoewear modification or wearing of orthosis to temporarily correct the deformity, thereby attempting to halt the progression.
Physiotherapy can provide stretching exercises and gait re-education as indicated. Patients with a significantly impacted quality of life by the condition can be considered for surgical intervention, for which there are a variety of procedures possible. The adage that “there’s more than one way to skin a cat” holds true in this condition. The surgical technique the surgeon utilizes mainly depends on the experience, mastery, and level of comfort he has of a certain procedure. To know which treatment is right for you, schedule your appointment with one of our foot and ankle surgeons to receive specialized quality expert care.
Procedures:
- Foot and Ankle Arthroscopy for Microfracture, Spur excision, Os Trigonum excision
- Plantar Fascia Release
- Tarsal Tunnel Release
- Ungiectomy (partial/total), Nail fold excision for Ingrown toenail
- Hallux Valgus corrective surgery
- Lesser toe deformity corrective surgery
- Bunionette correction
- Excision of Painful Accessory Navicular, Posterior tibial tendon reattachment
- Calcaneoplasty, Tendon of Achilles debridement for Haglund deformity
- Excision of Morton’s neuroma
- Lateral ankle ligament stabilizing procedures
- Deltoid ligament reconstruction
- Tendon transfer for Footdrop, Equinovarus deformity
- Tibiotalar, Subtalar, Midfoot arthrodesis for End-stage arthritis
- Superior Peroneal Retinaculum reconstruction for dislocating peroneal tendons
- Weil’s osteotomy for metatarsalgia
- Midtarsal foot amputation
- FHL transfer, VY plasty for chronic TA rupture
- Gastrocnemius recession, Tendon of Achilles lengthening for TA contracture
- Pes planus corrective surgery
- Pes cavus corrective surgery
- Complex Foot and Ankle trauma
- Cheilectomy for Hallux rigidus
- Supramalleolar osteotomy for Tibiotalar arthritis