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Treatment of Hallux Valgus- Results...
By Guest on 21st November 2022 07:37:41 AM | Syntax: TEXT | Views: 7

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  1. There are three distinct symptoms associated with <a href="">Hallux Valgus</a>. The pressure-sensitive protrusion on the medial side of the first metatarsal head that causes pain is called a bunion. It is painful to wear shoes. Additionally, the great toe's valgus deviation frequently leaves little room for the other toes. They move, typically upwards, which puts pressure on the shoe. This is known as a hammer or claw toe. Last, the great toe's pressure on the ground during gait is crucial to the forefoot's normal operation. The metatarsal heads II–V are overloaded because the valgus deformity prevents this from occurring sufficiently. Transfer metatarsalgia is the name given to the resulting pain.
  4. Diagnosis:
  5. When the patient stands barefoot, the lateral displacement of the great toe is evident (Figure 1). Additionally, using the vertex at the head of the first metatarsal, one can measure the angle between the longitudinal axes of the first metatarsal and the proximal phalanx of the great toe (hallux valgus angle). Although there is significant interindividual variance, an angle greater than 15° no longer corresponds to the norm (3). There are other deformities besides the great toe's valgus posture. The metatarsus is typically splayed, which heightens the prominence of the metatarsophalangeal joint. Additionally, the great toe is frequently slightly pronated, causing the nail to face medially.
  7. Conservative treatment:
  8. The great toe position can only be permanently improved while the skeleton is still developing. To shift the great toe to the medial side, a night splint may be recommended. After growth has stopped, it is no longer possible to correct the problem adequately, and conservative treatment is only allowed to manage the symptoms.
  10. Most patients have already switched to softer, broader shoes by the time they seek medical attention for their bunion issue. Ring pads and other dressings frequently fail and tend to make the bunion more obvious. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be given systemically in addition to antiphlogistic salves locally.
  12. Metatarsalgia:
  13. Only a few prospective randomized trials have been conducted to compare various surgical techniques or examine non-surgical options (Table 2). Only four articles (23, 29–31) in the entire body of published literature compared operating approaches, and none of them came to any conclusive results. This demonstrates the limitations of existing scientific understanding, particularly with regard to specific surgical questions. Depending on the patient's individual deformity, it will be decided if, for instance, the adductor tendon needs to be divided or the intermetatarsal angle straightened. It is difficult to randomize these methods without accounting for the precise malformation.
  15. Indications for surgery:
  16. Hallux valgus is not the right condition for cosmetic surgery. The risk that a patient who was previously symptom-free would experience pain for weeks or even months following the operation is far too high. The patient must experience pain that is not relieved by a simple change of shoes or other conservative treatments for surgical treatment to be indicated. Additionally, the pain must be consistent and must visibly affect how well the affected foot functions.
  18. Operative technique:
  19. The foot's soft tissue is so thin that it prevents wounds from healing properly. Additionally, due of the foot's distance from the heart, perfusion there is the worst. Last but not least, the foot experiences the most mechanical stresses of any human part. Due to these factors, the foot experiences wound healing issues more commonly than most other body parts, depending on the scope of the procedure and the patient's medical history. In our experience, the target is straightforward wound healing in at least 99% of patients. Therefore, special caution must be used when operating on the great toe. The ischemia period must be as brief as possible.

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