Hallux Valgus (Bunions)
Inflammation of the joint manifests itself as a lump on the side of the big toe. The big toe may possibly arch over the smaller toes. People with flat feet or with unusually flexible feet are at particular risk. Other causes are injury, rheumatic arthritis and neurovascular diseases. Women are more often affected, probably as a result of women’s footwear.
Normally pain develops around the bump due to rubbing caused by shoes. This rubbing against the shoe leads to a red, inflamed pocket of tissue, called bursitis. Over time, the pain can spread deep into the joint, affecting walking, sport, or even the ability to stand comfortably. If the joint is left misaligned over a number of years, osteoarthritis may develop. This causes increased stiffness and pain in the joint. The inflammation can also affect the surrounding toes. If the big toe begins to arch over other toes, it will exert increased pressure on the second toe or force it upwards. This leads to hammer toes or weals on the smaller toes.
The first step is to choose suitable shoes, with low heals, soft leather and large wiggle room for the toes. Cushioning reduces the pressure on the bump. Anti-inflammatory medication also provides relief.
If there is no improvement, corrective podiatric surgery should be considered. The longer surgery is postponed, the more advanced the arthrosis will become, thus rendering the operation more complicated.
The aim of corrective surgery is to realign the foot and to reproduce the normal function of the big toe joint. The first metatarsal bone and that of the metatarso-phalangeal joint are realigned to the correct position through different surgical procedures. The joint is thus preserved. In most cases post-operative therapy last around 6 weeks, without plaster, wearing a special shoe.