It is commonly called “onion”.
The Hallux Valgus is painful to walking and can complicate the fact of putting on. The vast majority of patients affected are women. “This is partly explained by the hormonal impregnation which increases the laxity of ligaments”, Can we read on the foot surgery site. Sometimes you have to operate.
What is the definition of a Hallux Valgus?
More commonly known as the foot onion, “Hallux Valgus is a deformation of the forefoot which can appear at any age (there are juvenile forms) and touches women more“, explains Justine Zamemego, podiatrist, trainer at the Toulouse podology institute. This is an abnormal deviation of the big toe to the second toe, at the level of the first metatarsal and the big toe. The lack of alignment of the big toe can lead to the formation of an” onion “, which corresponds to a bone protrusion.
Photo of a Hallux Valgus (diagram of an onion of the foot)
What is the cause of a hallux valgus?
The Hallux Valgus is most often congenital but it can be favored by:
- Heredity
- Age (it often starts between 40 and 50 years and menopause in women),
- Wearing too narrow and/or high heels,
- Static disorders of the foot such as the flat valgus foot
- Chronic arthritis
What are the symptoms of a Hallux Valgus? Painful ?
If it can be asymptomatic at first, the Hallux Valgus then evolves by thrusts which can be accompanied by strong pain on the inner edge of the foot, especially at night. These pains are accentuated by walking. “”There may sometimes be an inflammation in the joint of the big toe“Continues the podiatrist.
What examinations make it possible to diagnose a hallux valgus?
The diagnosis is clinical and radiological. As soon as there is suspicion of hallux valgus, “Better to take stock of a podiatrist to get treatment, prevention and possibly advice, be oriented towards a specialized surgeon“, Advises Justine Zamengo. In parallel, it is advisable to pass a foot x -ray to precisely measure the angle of deformation. The shots make it possible to assess the amplitude of the deformation and the degree of joint wear.
What are the possible complications?
The large toe ensures the propulsion of the body forward when walking. In case of hallux valgus, he loses this role of support of the body, which is then ensured by other toes. The loss of this function of the big toe aggravates the constraint exerted on the other toes and can be the cause of painful symptoms. Among other complications, let us quote:
- The appearance of bursitis (inflammation)
- The appearance of toe claws
- The appearance of dorillons on the soles of the feet
- Skin complications
- Risks of osteoarthritis
- The formation of a horn, which corresponds to a thickening of the corneal layer of the epidermis on an toe, and which forms as a result of friction in the shoes or high pressure on the skin during walking.
When to have a Hallux Valgus Hallux?
The operation is only reserved for truly disabled people because rehabilitation is long (at least a month) and painful. It can be considered:
→ In case of persistent pain (the hallux valgus is inflammatory)
→ In case of significant deformation
→ In case of appearance of a complication
Surgery consists in correcting the disintegration of the big toe outward (in other words, putting the big toe in its normal axis) by retraining of certain ligaments and the removal of the piece of protruding bone. The operation nevertheless gives good results (after convalescence, it removes pain, and makes its propellant role in the big toe). The intervention is carried out on an outpatient (or short hospitalization of 48 hours), under locoregional anesthesia and ankle tourniquet. “”In children, surgery can be avoided by carrying nocturnal orthotics or orthoplasties which will allow the deformation of deformation“Concludes Justine Zamengo.
Can we walk after an operation of the Hallux Valgus?
Walking is possible the day following the intervention. It requires wearing special shoes, in support of the heel, for a period of three to four weeks.
What rehabilitation at home after the operation?
Self-re-education exercises, which start approximately 15 days after the operation, occupy an important place in the recovery of the joint amplitude. Auto-re-education is based on so-called passive or active mobilization exercises. Passive mobilization consists in placing the thumb in support on the soles of the feet, and in exerting pressure on the large toe to push it down, gradually. This exercise, which has a draining effect on edema and which makes it possible to increase joint amplitude, is carried out in a comfortable position: most often in leafy, the operated foot brought towards you, the other leg outside the bed. The identical movements can be reproduced on each toe, and must be renewed 3 times a day, at the rate of 10 repetitions for each movement. The same type of exercise, without help from the push index, makes it possible to work in “active mobilization”.
What rehabilitation in physiotherapy?
Other exercises are added to the rehabilitation program once it is possible without “heel support shoes”, or about 1 month after surgery. They generally take place in the physiotherapist’s office. The sessions focus on recovering the propulsive support of the big toe, working on the course of the step. They are accompanied by other care depending on the case, such as manual lymphatic drainage in the event of persistent edema.
To protect the Hallux Valgus, it is recommended:
- To opt for suitable shoes, that is to say wide and without heels
- To use protections (such as those of the Epitact brand) reducing friction against shoes, which are sold commercially.
- Wearing orthopedic soles or nocturnal orthotics (to be done in the podiatrist), depending on the severity of the deformation, it is also possible to be made to measure by the podiatrist silicone (orthoplasties). By re-axing the foot and protecting it from the shoe, these protections relieve pain and avoid an increase in deformation.
Thank you to Justine Zamengo, podiatrist, trainer at the Toulouse Podology Institute and member of the Association for the Development of Podology.
