Hallux valgus is one of the most common deformities of the foot and consists of an outward deviation of the big toe. The condition often occurs bilaterally, especially in women, and is favored by flat forefoot conformation or factors that cause pronation of the hallux hallucis.

A major factor in the development of this deformity is inappropriate footwear - especially narrow, pointed-toed shoes - which cause a prolonged abnormal position of the big toe.

As it evolves, hallux valgus can affect the entire forefoot, causing plantar static disorders and aggravating the deformity.

Symptomatology

The main symptom is pain, which is initially dull but becomes progressively more intense, localized in the metatarsophalangeal joint. In advanced forms bursitis and nerve irritation, with pain radiating into the calf and sole.

• In mild forms (grade I-II), the pain only occurs when wearing shoes and disappears when walking barefoot.
• In advanced forms (grade III), the deformity leads to forefoot imbalance, and pain occurs with every step, even barefoot, without subsiding at rest. It can interfere with sleep and cause insomnia or discomfort at night.

General causes of forefoot deformities

The same causes that lead to hallux valgus can lead to other surgically treatable conditions, such as:

• Hallux rigidus (arthrosis)
• Deformities of the 5th finger (tailor's saddle)
• Digital pen (hammer fingers)
• Metatarsalgia (Morton's disease)
• Rheumatoid foot
• Congenital or acquired deformities

Common causes:

• particular foot conformations
• neurological, metabolic, rheumatologic diseases
• trauma or burns

Common symptoms:

• intense plantar pain when walking
• limiting walking distance
• increased pain when walking barefoot
• developing calluses (hyperkeratosis)

Treatment

Prophylactic treatment involves wearing physiological footwear, local hygiene and activities such as swimming and medical gymnastics.

Conservative treatment is applied in the early stages and includes wearing orthopedic shoes with plantar supports and pads to support the ball of the foot.

Surgical treatment is the solution for advanced cases. It aims:

• bone skeleton correction,
• muscle rebalancing of the first leg radius,
• maintaining the functionality of the foot.

The aim of the intervention is a pain and deformity-free foot, restoring the patient's walking comfort and improved aesthetics.