Non-surgical treatment of hallux valgus

  • Choosing appropriate footwear – shoes should be sufficiently wide, shaped to the size and form of the deformity, have a soft sole and adequate toe-box height. The aim is to reduce pressure on the big-toe metatarsophalangeal joint. If other forefoot deformities, such as hammer toes, are present, they should also be considered when choosing footwear.
  • Use of corrective devices – these can relieve local inflammation, but unfortunately do not reduce the deformity or affect further disease progression.
  • Orthopaedic insoles – mainly useful when hallux valgus is accompanied by flatfoot, metatarsalgia or valgus alignment of the hindfoot.
  • Drug treatment – topical non-steroidal anti-inflammatory drugs, usually as an ointment, gel or spray, can temporarily reduce symptoms caused by local inflammation in many cases.
  • Physiotherapy, for example iontophoresis with an anti-inflammatory drug

Hallux valgus – surgical treatment

If the deformity worsens and pain increases, surgery is the only effective treatment.

The development in recent years of new foot-surgery solutions that avoid plaster immobilisation while allowing early walking has increased interest in foot-surgery problems among both physicians and patients.

There is no single universal method suitable for every case of hallux valgus. This is because the deformity can arise from different causes.

Before surgical treatment of hallux valgus, the patient undergoes a thorough examination.

We then discuss the deformity with the patient, including whether it is associated with hypermobility, and explain the proposed surgical options. Finally, we describe the risks of the procedure itself and possible complications during surgical treatment of hallux valgus.

If hallux valgus affects both feet and the size and severity of the deformity allow it, we operate on both feet during the same session.

Diagnostic tests used before hallux valgus surgery

  • Radiographic examination in standard views (it is extremely important that the images are taken under full weight-bearing)
  • Haematological and biochemical tests (preoperative recommendations)
  • Pedobarographic examination, still rarely used in Poland, which assesses pressure distribution on the soles while standing and walking and therefore allows more precise planning of surgery.
  • Ultrasound examination
  • Computed tomography
  • Magnetic resonance imaging

Surgical methods used to treat hallux valgus:

  • Chevron technique
  • Scarf technique
  • MICA
  • Lapidus procedure (arthrodesis of the first tarsometatarsal joint)
  • Proximal osteotomies
  • Modifications of the above methods
  • Arthrodesis of the big-toe metatarsophalangeal joint