An increasingly common problem in medicine is foot malpositions and deformities, which can be caused by incorrect footwear, for example. The consequences are pain, cramps and malpositions as well as inflammation of the joints. Shoes that are too high or too tight, which exert a compression on the foot and especially the toes for years, lead to a malposition of the metatarsophalangeal joint of the big toe.
In this case, the big toe deviates from the straight basic position in the direction of the other toes. Through the pressure of the big toe on the other toes, these are compressed and give way to this pressure by forming hammer or claw toes. These are not only aesthetically disturbing, but also aggravate the foot malposition.
The other toes as well as the ball of the toe can also begin to hurt due to the increased pressure. This can also lead to unsightly joint inflammation, which causes the joint capsule to become weaker and weaker. This clinical picture is also called hallux valgus.
If the hallux valgus is already very pronounced, it can lead to gait insecurity and incorrect loading, whereby the gait pattern changes considerably and other joints, such as the ankle joint, are also affected. This usually severely restricts the patient’s quality of life and gradually leads to immobilization. In most cases, surgery is the only alternative to correct this severe malposition.
If the patient waits too long, the joint and the metatarsus become increasingly stiff. The secondary disease of a hallux valgus is a hallux rigidus. This describes an arthrosis of the metatarsophalangeal joint of the big toe, which is caused by the defective position and increased strain.
Young women are particularly affected by this condition, as they often wear heel shoes and attach great importance to the fashionable appearance of the shoes, but too little importance to comfort. In addition, the foot sends too few pain stimuli to the body when under constant pressure, it tends to get used to the pain and the wrong shoe, so that symptoms and severe pain and inflammation only occur when the foot skeleton is severely malpositioned. In this case, surgery is usually the only way to bring about permanent pain relief, but this bone repositioning operation is a major intervention and should only be carried out if there is considerable suffering and severe pain.
During the operation, the bone malposition is corrected, the balance of tendon and muscle tension is restored with the direction of the bone, and the joint capsule is tightened as an additional stabilisation measure. Depending on whether full weight bearing is desired as quickly as possible or a sufficiently long healing time is possible, more or fewer implants are used. Metal implants and screws help to fix the bone repositioning, but they are foreign material for the body and can therefore also make scarring and healing more difficult.
As an alternative to this surgical procedure, there are some preventive and palliative measures that can help, especially in the early stages of the disease. These include, in particular, the special Hallux valgus shoes and special support aids, which are intended to relieve the toes and forefoot. Various models of the special Hallux valgus shoes can be used as a preventive measure, as a way to improve pressure and pain in existing Hallux valgus or as a forefoot relief shoe after a Hallux valgus operation.
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