The hallux valgus is a very frequent foot condition; it affects women in particular and it is characterized by the deviation of the hallux towards the other fingers.

It is often accompanied by a hammer-finger, i.e. an overlap of the second finger of the foot with the big toe. The second toe of the foot tends to bend upwards and overlap the deflected big toe, “in this way the toe often sticks against the shoe, which is why the patient usually turns to the orthopedist”, explains Dr. Leonardo Maradei, Head of foot surgery and minimally invasive surgery in Humanitas.


The causes of hallux valgus

The deformation can be due to a variety of causes; family history plays a key role. The use of footwear that fatigues the foot, such as flat shoes, narrow tip shoes and shoes with a high heel can speed up the appearance significantly. In other cases, valgus toe may be due to injuries to the foot, the presence of other diseases (such as certain types of arthritis) or problems with weight, posture or muscle tone.


What do I do in case of hallux valgus?

“The valgus toe requires a specialist orthopedic examination, this condition alters the way of walking and leads to an overload of the metatarsi.

The treatment can be conservative, with the use of corrective insoles, but in most cases, when it becomes symptomatic, the solution is surgical.

Traditional surgery, through the surgical opening of the skin and the underlying tissues, allows the correction of deformity through the removal of a part of bone and the execution of osteotomies with the insertion of supports to bring the big toe back into the correct position,” explains Dr. Maradei.


Minimally invasive surgery

“In addition to traditional surgery, there are other procedures, such as Percutaneous Distal Osteotomy (PDO), which involves percutaneous osteotomy, i.e. through an incision of a few millimeters. The correction is maintained with the insertion of a metal wire (called Kirschner’s) that will be removed after four weeks in the surgery.

Mini-invasive surgery (called MIS) plays a leading role, where the indication allows it, allowing to correct the hallux valgus and also to intervene for the correction of the second hammer finger and other deformities, through small incisions of the skin and without using means of synthesis.

The advantages of these minimally invasive procedures are manifold: less pain for the patient, reduced risk of infection and necrosis of the skin and rapid recovery, because the patient starts walking again immediately after surgery. However, the definitive recovery requires biological time for the bone to heal.

In the case of the PDO, the patient will have to wear an orthopedic shoe that will allow him to walk immediately; in the case of the MIS, instead, he will have to wear a comfortable shoe for a month,” concludes Dr. Maradei.