Hallux valgus in Tunisia
Definition of Hallux Valgus
A bunion is a painful bony bump that develops on the inside of the foot at the big toe joint. Bunions are often called hallux valgus. Bunions develop slowly. Pressure on the big toe joint causes the big toe to lean toward the second toe. Over time, the normal bone structure changes, resulting in the bunion bump. This deformity will gradually increase and can make wearing shoes or walking painful. Anyone can get a bunion, but they are more common in women. Many women wear narrow, tight shoes that squeeze the toes together, increasing the risk of developing, worsening, and having painful symptoms from a bunion. In most cases, bunion pain is relieved by wearing wider shoes with enough room for the toes and using other simple treatments to reduce pressure on the big toe.
Indication of Hallux Valgus
A bunion forms when the bones that make up the MTP joint move out of alignment: the long metatarsal bone moves toward the inside of the foot and the phalanx bones of the big toe tilt toward the second toe. The MTP joint enlarges and protrudes from the inside of the forefoot. The enlarged joint is often inflamed. The word "bunion" comes from the Greek word for turnip, and the bump on the inside of the foot is typically red and swollen like a turnip.
Non-Surgical Treatment of Hallux Valgus
In most cases, bunions are treated without surgery. Although non-surgical treatment cannot actually "reverse" a bunion, it can help reduce pain and prevent the bunion from worsening.
Surgical Treatments for Hallux Valgus
Orthopedic surgeons are clear: surgery is not performed for aesthetic reasons. It is the pain and failure of treatment with orthopedic insoles or braces that justify the operation, as preventive surgery does not exist. These unanimous precautions highlight the seriousness of such an intervention. And for good reason, classical surgery, "open surgery," with its Scarf or Chevron methods, involves an osteotomy, meaning bone cuts under general anesthesia. Screws, staples, and pins are implanted to fix the bones in their new alignment. This technique is now giving way to percutaneous or "minimally invasive" surgery, imported from the United States to European clinics in the early 2000s. The operation is performed directly through the skin, using much smaller incisions. A mini-burr is introduced to shave the bone, while the procedures are controlled by X-ray. Performed on an outpatient basis with local anesthesia, it allows the foot to be placed flat within a few hours and sometimes requires the permanent placement of titanium screws to prevent any risk of recurrence.
With no zero risk of recurrence, there is also a long and restrictive recovery period. While postoperative edema and discomfort are common, in theory, it takes 4 to 6 weeks to resume normal footwear with wide shoes, such as sneakers. From the 6th week, light sports activity is possible, while jogging, hiking, or tennis are allowed after 3 to 6 months. But in practice, many patients still suffer several years after their operation. Swollen feet, difficulty walking, inability to drive, bruising, sensitive tendons, and bothersome pins impair quality of life... Presented as effective and painless, hallux valgus surgery handicaps and isolates, more than one might think, those who saw in it the possibility of a return to normal and the end of their pain.
Postoperative Care for Hallux Valgus
Walking with the medical shoe is allowed without restrictions. During the first week after surgery, you must respect rest periods for your foot by keeping it elevated. Prolonged walking can cause increased swelling of your foot and pain. It is forbidden to walk barefoot during the first month.