Hallux valgus
Understanding this condition
Hallux valgus, commonly called a "bunion", is the most frequent deformity of the forefoot. It is a lateral deviation of the big toe (which angles towards the other toes) combined with a bony prominence on the inner border of the foot (the first metatarsal head protruding).
This deformity is progressive and multifactorial: family predisposition (the main factor), foot morphology, wearing high-heeled or too-narrow shoes, and ageing. It predominantly affects women.
Symptoms
Initially, the aesthetic appearance and difficulty fitting shoes dominate. Pain then develops over the inner "bump" (rubbing with the shoe), sometimes with inflammation.
As the condition progresses, the big toe may overlap or pass under the second toe, creating a cascade of deformities (hammer toes), corns, and calluses under the forefoot (metatarsalgia).
How can it progress?
The deformity worsens over time. Shoes become increasingly difficult to wear. Pain spreads to the entire forefoot.
At an advanced stage, osteoarthritis of the big toe joint and complex deformities of the other toes develop, making surgery more complex if it becomes necessary.
Treatment options
While symptoms are moderate: appropriate footwear (wide, soft, without high heels), orthopaedic insoles, orthotics (silicone toe separators). This provides relief but does not correct the deformity.
When pain or deformity becomes disabling, surgery is proposed. Several techniques exist (metatarsal osteotomies, soft tissue releases), chosen according to severity. Modern techniques allow minimally invasive surgery with immediate weight-bearing. A consultation allows planning of the appropriate procedure.