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What is hallux valgus

Hallux Valgus (valgus deformity of the position of the big toe) or bunion is a term that means deformi-ty at the level of medial metatarsophalangeal joint (joint at the bottom of the big toe) with valgus joint (lat. valgus – distorted), it is characterized by medial deviation of hallux (big toe, lat. arteculato meta-tarsophalagealis).

Hallux valgusThere are a lot of factors (reasons) for development of this deformity. The genetic factor of this disease is the most common, also wearing badly chosen uncomfortable shoes that overload the forefoot com-presses toes and makes them to be a long time in an uncomfortable position. In terms of anatomy, the problem of wearing such footwear is in overloading of forefoot and in violation of components of metatarsophalangeal joint (medial deviation of the first metatarsal bone and lateral deviation of hallux). Between the bones formed first metatarsophalangeal joint (joint at the base of the big toe) there is an angle that is open toward the other toes on foot. Following this, muscles of foot begin to react: some muscles are overstrained, others begin to relax, that increases the problem of treatment. This muscle imbalance assists to wrong position of metatarsus and phalanges of toes, in a result external mechanical impact on metatarsus-phalangeal joint increases (foothold on the ground and the pressure of foot-wear), the process of overgrowth of scar and bone tissue begins in the joint and bunion appears.

So in the base of valgus deviation of big toe is development of longitudinal-transverse flatfoot (flatten-ing of longitudinal and transverse arches of foot) that disturbs biomechanical relationships in joint of foot while walking and starts the chain of pathological processes it will lead in the beginning to the development of compensatory processes then to decompensation of processes.

Treatment and surgery of Hallux Valgus

There are predisposing factors that contribute to the development of forefoot:

  • overweight
  • wearing narrow shoes with high heels
  • prolonged static load on feet
  • congenital deformities
  • foot injuries
  • congenital weakness of ligamentous apparatus
  • diseases in which there is a violation of nervous regulation of shin and foot muscles (for example polio)

Symptoms and diagnosis Hallux valgusSymptoms and diagnosis

Patients complain of pain in I metatarsophalangeal joint. Pain becomes stronger after long stay on feet and decreases when feet rest. You might have night pain, particularly after a significant load on foot. Pain can considerably vary both in nature and in power from discomfort (usually at early stages) to sharp burning or nagging pain.

Hallux valgusFoot becomes more and more incorrect, expands and flattens when deformity develops, big toe “lies” on second one, also quite often there are attendant deformities of second toe. All of this combined with bunion in the projection of I metatarsophalangeal joint significantly affects on the appearance of foot. So along with pain, the reason of treatment of patients in traumatology and orthopedics is often in a cosmetic defect and in a selection of footwear. Young women often have such complaints.

During visual checkup foot is flattened. Visible deformation and insignificant or moderate hyperemia reveal in the projection of I metatarsophalangeal joint. Big toe is deflected outward at the angle to the others. Palpation is painless, bone exostosis and skin seal are determined on the inner surface of foot in metatarsophalangeal joint. It may be a small local swelling. Movements in I metatarsophalangeal joints are usually limited (restriction level of movements may considerably vary), pain may occur with maximum extension of toe.

Hallux valgusHallux valgusDiagnosis of Hallux valgus is exposed on the basis of symptoms and information of X-ray examina-tion. Then specialists do radiography of I metatarsophalangeal joint. For more accurate assessment of disease from neighboring anatomical structures prescribe X-ray of II and III metatarsophalangeal joints. Level of severity is determined by taking into account two variables: angle between I and II metatar-sals (intermetatarsal angle) and angle at which a big toe is rejected in relation to I metatarsal bone. There is a need to do a surgery for treatment.

There are 4 stages of bunion deformity of the big toes on feet

Hallux valgus

I stage: – malpositioning of big toe below 30 degrees. Malpositioning of step bone around 20 degrees. Angle between I and II instep bones around 13 degrees.

II stage: - malpositioning of big toe between 30 and 45 degrees. Malpositioning of step bone between 25 and 30 degrees. Angle between I and II instep bones between 14 and 17 degrees.

III stage: - malpositioning of big toe more than 45 degrees. Malpositioning of step bone between 30 and 50 de-grees. Angle between I and II instep bones more than 17 degrees.

IV stage: – malpositioning of big toe more than 50 degrees. Big toe lays on the second one and form cross and pain on everyday activities. It is impossible to select comfortable footwear.

Our clinic in Germany offers unique surgery. Treatment of Hallux valgus in a unique short rehabilita-tion period – in 1,5 hours after surgery you can stand and walk without any gypsum, special shoes and crutches! Home mode with dosage load on feet is supposed during 10 days after surgery. After 10 days you will return to your normal life!

minimum of inconvenience

minimum of pain

excellent result

beautiful feet


For information: surgery of removing bunion can be done in any city in any country even free of charge, because this surgery is in the list of free municipal surgeries. But it will be done with usual classical technique, possibly with titanium screws that have to be removed, with wearing special footwear (Baruka) during few weeks and using crutches. And after surgery a recovery will be a long process up to six months. Our method is unique, only three surgeons in the world do that operation using this technique and two of them are in our clinic.

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