Orthopaedics & Sports Medicine

What is Hallux Valgus?
Hallux valgus refers to the deviation of the big toe, commonly known as a bunion. It is more prevalent among women and often affects both feet. The main cause is wearing shoes with a narrow toe box or high heels, which force the big toe towards the other toes. Over time, the deformity becomes fixed. Individuals with flat feet are more susceptible. 

When the deformed toe rubs against footwear over time, a bursa may form beneath the skin. This can become inflamed and swollen, causing pain and limiting joint movement. In severe cases, the joint of the big toe may degenerate, adjacent toes may become deformed and corns may develop on the sole. 

Methods of Treatment
For mild cases, pads may be placed beside the big toe, between the toes or under the sole. Avoiding narrow or high-heeled shoes is essential. When pain becomes severe or other toes are affected, surgery is often the only effective option. 

The Operation
The choice of procedure depends on the severity of the condition: 

• Mild cases – The bunion is removed and the toe deformity corrected through soft tissue reconstruction or bony realignment.
• Severe cases – If the joint is damaged, fusion may be required. Deformities in other toes are corrected at the same time. 
   

Possible Complications
Post-operative complications following hallux valgus surgery are uncommon, though certain factors may affect recovery. Common complications include: 

• Deterioration of pre-existing diseases such as cardiac disease, hypertension, stroke and diabetes mellitus
• Wound infection or healing problems
• The metallic implants might be felt under the skin and cause pain
• Delayed or poor healing of bone cuts
• Decreased mobility of toes
• Nerves damaged causing numbness
• Recurrent deformity or over-correction leading to reversed deformity 
   

Related prosthetic & Orthotic services
Patients are advised to become accustomed to using custom-made insoles and night toe splints. In addition, changing footwear habits – such as avoiding shoes with narrow toe boxes – can help minimise symptoms and improve comfort.