Hallux valgus is that the big toe turns outward and the root shrinks inward, which makes the root grow a big bulge and makes the front foot look like a triangular "big snake head", which is called hallux valgus (commonly known as "foot inversion, big foot cup"). If it affects the patient's shoes, it will also cause pain. If it is not treated, the deformity and pain will gradually increase, which will seriously affect the position of other toes and joints, and it will easily lead to calluses on the soles of the feet. The big toe turns outwards, squeezing the second toe, occupying the position of the second toe, lifting the second toe to overlap with the big toe, so that the metatarsophalangeal joint of the second toe is overstretched, and the joint between the near toes bends into a hammer toe, protruding from the back of the big toe and the third toe. The back of the joint between the proximal toes is rubbed and squeezed by the vamp, which can also cause callosum pain. The lesion gradually develops, the cartilage of the thumb joint is destroyed, the bone is proliferated, the joint space is narrowed, and it is more painful. Hallux valgus is usually found by patients themselves, and the most common symptom is the pain of bunion. The long axis of the big toe of normal people forms an acute angle with the long axis of metatarsal bone, which is about 15. There is also varus within 9 between the first metatarsal and the second metatarsal. If the inclination of the big toe exceeds the above angle, accompanied by the pain of the big toe cyst, it can be diagnosed as hallux valgus.
2. What are the hazards of hallux valgus?
① Pain is the main symptom, mainly from the inside of the first metatarsal, which is aggravated when walking. The big toe curls outward, and then the bone at the root of the big toe protrudes. After protruding, this bony protrusion will grind the upper when you wear shoes. Over time, it will cause inflammation and pain. This is called bunion in our medicine, and it will cause infection after local ulceration. If hallux valgus lasts for a long time, you can also push the second toe upward to form a vertical toe. If the vertical toe is serious, it will grind the upper on the back side and cause pain. Some patients suffer from calluses (calluses or "corns") on the metatarsal surfaces of the second and third metatarsals. This is because hallux valgus will lead to the collapse of a transverse arch under the soles of the feet, which will increase the stress of the second and third toes and reduce the stress of the big toe. Hallux valgus deformity is not proportional to pain, and some deformities are obvious, but the pain is not obvious. Too much walking hurts badly. It is difficult to wear shoes, especially for these people to buy a pair of suitable shoes. (3) the appearance is not beautiful, and the root of the big toe protrudes more than others. ④ Psychological influence. Bring inconvenience and pain to work and life. Many patients suffer from hallux valgus for a long time, unable to participate in social activities, and even have difficulty walking, which brings great inconvenience to life. Some patients even feel inferior for aesthetic reasons. However, after the treatment of hallux valgus, patients can move in social places again. The treatment of hallux valgus is of great significance to improve people's quality of life and protect the labor force.
3. What is the incidence of hallux valgus?
Hallux valgus is a common foot disease. The incidence of female is 20%. The incidence rate abroad accounts for 50%, but there are also some genetic and acquired factors. Puberty and middle-aged and elderly people (after 40 years old) are prone to onset, especially female patients around 45 years old. Hallux valgus is also proportional to age. The older you are, the more serious your deformity is. Genetic factors can occur in adolescence, with more females than males, and the incidence ratio of male to female is 1: 19. In recent years, the number of women wearing high heels in China has increased, and its incidence is on the rise. The incidence rate abroad is higher than that in China, and the incidence rate in the north is higher than that in the south, which is related to the habit of wearing high heels and pointed shoes. The incidence of long-term standing workers such as teachers, nurses, salespeople and hairdressers has increased significantly.
4. Why do you suffer from hallux valgus?
At present, the cause of the disease is not clear. The reasons are: 1, genetic factors (80% genetic factors, 70% maternal inheritance); 2. Wear inappropriate pointed shoes and high heels; 3. Inappropriate load bearing for a long time, standing and walking for too long; 4. Suffering from other diseases, such as rheumatoid arthritis, rheumatoid arthritis, often resulting in subluxation due to joint destruction, manifested as hallux valgus deformity. Flat feet (commonly known as flat feet), metatarsal 1 is too long and too short.
5. What do you think?
Including non-surgical treatment and surgical treatment. Mild valgus and mild pain can be treated by non-surgery, while severe deformity and pain can be treated by surgery. The most effective treatment for hallux valgus is surgery. There are more than 200 kinds of surgical methods, and which method to treat depends on different people. At present, there is no surgical method that can "cure 100 people". Surgical methods include: soft tissue surgery, osteotomy, combined surgery, artificial joint replacement surgery, arthroplasty and joint fusion. It is unscientific to choose the treatment method according to the condition, and all patients are treated by the same surgical method. Each operation has its own characteristics, and the excellent and good rate of operation is about 70% to 90%. The treatment of hallux valgus is an unsolved problem in orthopedic surgery, and no treatment method can guarantee no recurrence. So everyone is studying ways to reduce recurrence. Together with Huashan Hospital of Fudan University, we put forward a new classification method of hallux valgus to help the choice of surgical methods. This method was recommended in the review of China Orthopedic Journal, and has been adopted by the Foot and Ankle Surgery Group of China Orthopedic Society, and will be included in the "Clinical Physician's Diagnosis and Treatment Standard" of the Ministry of Health. Our creation of "Reconstruction of Transverse Arch of Foot for Hallux valgus" makes hallux valgus surgery progress from two-dimensional correction to three-dimensional correction, from local deformity correction to comprehensive correction, from empirical qualitative classification to systematic quantitative classification, which improves the curative effect and reduces surgical complications. Another popular trend in recent years is to use small incision osteotomy to treat hallux valgus. Small incision osteotomy for hallux valgus has the characteristics of less trauma, small incision, no need of plaster and steel needle, quick healing, less pain and mobility after operation. We are studying the microporous operation of hallux valgus with smaller incision.
6. To what extent does hallux valgus require surgery?
The main purpose of treating hallux valgus before was to relieve pain. Generally, surgery should be performed when walking is affected and there is pain, and painless or painless deformity should not be corrected. And with the improvement of people's living standards. Some patients, mainly young female patients, can't wear fashionable shoes because of their ugly appearance. Or because some venues need to wear high heels, but they are too painful to wear. About 20% patients with hallux valgus come to see a doctor because of their beautiful feet, not because of pain or limited function. And more than 70% of patients made it clear that they hope to eliminate the "ankle crutch" that has accompanied them for many years through treatment. This requirement is especially common among young white-collar women.
7. Can hallux valgus surgery completely return to normal?
Of course.
8. Can the elderly have surgery?
The old man can't wear shoes because of unbearable pain and needs surgery. If the heart and lung function is good and there is no systemic infection, you can do this operation. We have operated on male patients in their seventies.
9. Hallux valgus is not heavy, but the cocoon under your feet is very heavy, and it hurts badly when you walk. Can it be cured?
Surgery can be performed, but if it is mild, it can also be treated conservatively, such as using a foot pad. Because hallux valgus will cause the arch of the foot to collapse and flatten, the first metatarsal corresponding to the big toe will bulge, and the second and third metatarsal corresponding to the second and third toes will bear too much weight and friction, resulting in the skin thickening and calluses. For such cases, osteotomy should be used for three-dimensional correction, and operations such as rotation, pressing and pushing should be carried out during the operation. This is the first "reconstruction of transverse arch of foot" in China to treat hallux valgus.
What is the best age for hallux valgus surgery?
The sooner you get hallux valgus, the better. If bone surgery is to be performed, it must be performed after the epiphysis of the child is closed (16- 18 years old).
12, hallux valgus deformity is not very serious, can you not operate? If so, how to treat it?
For mild hallux valgus, the big toe of the foot can be moved to the inside of the foot without surgical massage. For example, tie a 1 comfortable rubber band between two big toes, and pull in the opposite direction four times a day for 5- 10 minutes each time. Or put rubber strip on all toes, and the toes will separate. If bunion happens, you can do physical therapy and hot compress, wear loose shoes to avoid foot compression. You can also put a cotton roll between the first toe and the second toe or tie a splint on the inside of your foot at night to straighten your toes. At the same time, you can walk barefoot in the sand, you can also exercise to catch things with your toes and exercise your foot muscles, or you can wear orthopedic shoes and flat foot insoles to correct your flat feet.
13, hallux valgus will get worse if it is not treated? What should I pay attention to?
Hallux valgus can often be aggravated by the weakening of foot muscle strength in middle-aged and elderly people, and the degree of deformity is proportional to age. The older you get, the more serious your deformity is. You can keep fit. When choosing shoes, you should pay attention to avoid wearing high heels, pointed shoes and shoes with hard materials. Among women with hallux valgus, 80% wear high heels or pointed shoes when they are young. It can be said that the higher the heel and the sharper the toe, the greater the probability of hallux valgus.
14. Can dancers continue their dancing career after hallux valgus surgery?
It should be possible.
15. What about hallux valgus caused by severe rheumatoid arthritis?
At present, our department adopts excision and plastic surgery or artificial toe joint replacement for patients with severe rheumatoid foot, which makes many patients who can't walk because of foot disease stand up again and move towards a new life.
16, how to prevent hallux valgus?
Hallux valgus is a common and frequently-occurring disease, and it is very important to prevent or avoid its aggravation. Prevention is mainly: 1. When choosing leather shoes, you must choose a comfortable style according to your foot type. The upper should not be too hard, the heel should not be too high, and the toe should not be too pointed. Try to choose front shoes instead of high heels. Especially when exercising or traveling. If you must wear high-heeled shoes for some work or occasions, you should change them immediately after you go home, and often soak your feet with hot water to relieve soft tissue spasm. 2. For lighter hallux valgus, you can put rubber bands on both thumbs and pull them together. Do 1 twice a day for 5 minutes each time. 3. In childhood, shoes that become smaller should be replaced at any time. The upper should not be too hard and the front of the shoe should not be too narrow. Children should not wear high heels. Teenagers who are in the period of growth and development, their feet are constantly developing and growing, and they are not suitable for wearing narrow pointed shoes. 4. If the patient suffers from diseases such as corpus callosum, flat foot or heel pain, metatarsal pad, flat foot pad or heel pad can also be used at the same time. We should prevent and treat flatfoot.
17. Why do pointed leather shoes cause hallux valgus?
Pointed shoes can cause hallux valgus. Because the toes are pointed, they can't normally accommodate the toe width. Due to the pressure of the upper, the thumb has to move inward, and the heel of the thumb is squeezed outward, thus forming "hallux valgus". Severe hallux valgus will cause bunions due to the friction between the protruding part of the thumb root and the upper. . Wearing pointed high heels may be more harmful. The foot is the second heart of the human body. Once the toes are squeezed by the narrow toe, the blood circulation will be affected, which is not conducive to the health of the feet. Because the front of pointed shoes is triangular, when standing in high heels, the front of the foot is forced to enter a narrow triangular area, while the upper is made of leather and has no elasticity, so the big toe is forced to evert.
19. Will wearing high heels cause hallux valgus?
Another reason for hallux valgus is the popularity of high heels. /kloc-before the 0/8th century, the style of French shoes was flat-bottomed buckle belt. There were few cases of hallux valgus reported at that time, but since the appearance of high heels, hallux valgus has become more and more common in France. Look at Japan again. Before 1960s, people used to wear clogs, and there was no record of hallux valgus. After the 1960s, the westernization of life and the incidence of hallux valgus increased in direct proportion. The incidence of hallux valgus is obviously higher among flight attendants and white-collar women, which can also explain the relationship between hallux valgus and high heels. Studies have shown that when the heel is too high, the weight borne by various parts of the foot changes, the weight borne by the front part of the foot, especially the big toe, increases by five times, the ligament of the joint relaxes, and the normal anatomical structure changes due to the extrusion of the tip, leading to hallux valgus. After wearing high-heeled shoes, the center of gravity of the body moves forward, and the load on the toes increases, so that the front of the foot, which is roughly square, is forced to squeeze into the narrow toe of the cone, which makes the feet suffer greatly, easily induces hallux valgus, and even involves the waist through the reflex mechanism, causing low back pain. Therefore, it is recommended that you wear less high heels, especially for patients with low back pain. In addition to wearing high heels in social occasions, etiquette and other specific occasions, ordinary people still wear ordinary cloth shoes or leather shoes. The heel should not be higher than 3 cm, and the sole should have a slope. Shoes with heels above 4-6 cm exceed the health care standard.
20. Why is the treatment of podiatry important?
Foot disease is a common problem nowadays. Foot disease, which was neglected before, has become one of the diseases that affect people's quality of life. One in every two people in our country suffers from foot disease. Since 1998, China has held a foot care week once a year, reminding people with different eye-catching slogans every time: Look at your feet, they are not as well protected as your face. The best way to avoid foot disease is to pay attention to your own feet. Because the face faces many people and things every day, it is often valued. The hand is a woman's second face, and the degree of attention is also very high. Feet are often hidden in shoes, which give them a shiny appearance, but they are often ignored. Shoes are beautiful packaging of feet, but sometimes they are also beautiful enemies of feet. The fatal point of this dangerous adultery is that people who love beauty often pay one-sided attention to appearance. According to the survey, in all kinds of tinea pedis, except tinea pedis caused by fungal infection, onychomycosis and other diseases, it is often caused by improper wearing of shoes and excessive pedicure.
2 1, hallux valgus can be treated with drugs?
Generally, it can't solve the problem, but can only temporarily relieve the pain.
22. Is hallux valgus hereditary?
Adolescent hallux valgus tends to be familial. If it is caused by genetic factors, it will occur at an early age, and the symptoms will get worse with age. If it is caused by non-genetic factors, women are generally prone to get sick after menopause. According to the research data of many scholars in Europe and America, hallux valgus is obviously related to heredity. 195 1 and 1980 foreign journals of osteoarthrosis surgery show that 63% and 68% of hallux valgus patients have family history in these two periods, indicating that genetic factors have been relatively stable. There are similar reports in China, mainly maternal inheritance. Obviously, if parents have hallux valgus, children should prevent it as soon as possible.