Hallux treatment surgery

Hallux is a common term which refers to the big toe deformation. The name comes from the Latin term Hallux Valgus (bunion). Hallux is an acquired disease of the foot and females are more commonly affected by this condition. .

This arthritis condition is usually accompanied by fallen transverse arch. Deformity of the big toe is usually caused by various deformation of the first foot bone (metatarsal), the head of the metatarsal bone is elevated and subluxation of the hallux metatarsal phalangeal (MTP joint). There may appear a painful bump on the head of the metatarsal bone with bursa inflammatory condition the so called bunion or big toepronation. Lateral deviation of the big toeaxis may often cause the elevation of the second toe thus leading to the mallet toe with painful callus in the back of it and claw toe deformity of other toes.

Patient benefits:

  • It is a one day procedure;
  • Significant reduction of painful ailments;
  • Enhanced walking efficiency;
  • Recreation of normal forefoot anatomy.

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Specjalists and egibility:

Eligibility for a surgery is usually determined during an orthopaedic consultation appointment and on the basis of X-rays. Patients suffering from other diseases may require opinions of other specialists.

Determining eligibility and procedures are performed by

Dariusz Mątewski, MD PhD
Specialist in orthopaedics and traumatology

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Price list, refunds provided by insurance companies:

  • Cost of verifying a patient’s eligibility for the procedure is 100 €;
  • Cost of hallux valgus operation on 1 foot amounts to 1,500 €;
  • Follow-up appointments up to 4 weeks following the procedure – free of charge.

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Disease symptoms and eligibility for the hallux treatment procedure:

  • Painful bump on the head of the metatarsal bone with bursa inflammatory condition the so called bunion;
  • Lateral deviation of the big toe axis in the metatarsal phalangeal towards other toes;
  • Elevation of the second toe and thus leading to the mallet toe with painful callus in the back of it and claw toe deformity of other toes.

The fallen transverse arch which frequently accompanies this arthritis condition often causes pain in the forefoot sole, located underneath the perceptible head of the second and third metatarsal bone on the borderline of individual toes.

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Treatment options for hallux:

Non-surgical management for hallux condition usually brings insignificant improvement. Special soles for night  for hallux treatment (Apparatus Marcin, Hallufix) or triangular abduction splints to be used inside the shoe during the day may also help reduce pain for a short period of time.

Special metatarsal soles may sometimes control symptoms – providing support to the transverse arch of the foot. It is important to wear adequate flat shoes which are widened in the toe part. However, regardless of applied corrective soles or shoes this arthritis condition will recur if there exist predisposing factors.

Therefore the only effective treatment method for the rigid big toe is a surgery, which is intended to reduce pain ailments and improve the walking efficiency by recreating normal forefoot anatomy.

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Pre-op preparation:

Before the surgery you are recommended to:

  • Have an anterior-posterior (AP) and lateral (horizontal radiation) X-ray of both feet wearing shoes and bearing the weight of your whole body;
  • Have a chest X-ray;
  • Get laboratory tests necessary for anaesthesia purposes;
  • Heal all inflammatory conditions, in  particularpurulent ones in the area of the foot and lower limb to be operated.

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Treatment options:

Surgical techniques for hallux can be divided into:

  • Arthroplasty of MTP I soft tissue + removing the bone spur of the first metatarsal bone;
  • Distal osteotomy of the first metatarsal bone, chevron type + arthroplasty of MTP I soft tissue;
  • Osteotomy of the first metatarsal bone, scarf type + arthroplasty of MTP I soft tissue;
  • Proximal osteotomies of the first metatarsal bone + arthroplasty of MTP I soft tissue.

Using modern surgical fusion techniques, osteotomies with the use of special screws or plates and screws allows avoiding a plaster during the postoperative period as well as a relatively quick return to normal footwear.After the procedure you may not expect persistent pain, your foot will not be immobilized for several weeks and your walking will not be limited for a long time any longer.

The choice of the relevant surgical technique depends on the kind and progression of deformity. Hallux corrective surgery which is performed correctly and soon enough prevents the foot from deformity recurrence.

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Recovery:

Until the time of stitch removal you are advised to:

  • Spare you operated leg and keep it in an antioedematous position, that is above the groin level. Sparing your foot does not mean you have to lie, that is why only 2-3 days following the surgery you may start walking using elbow crutches and special post-op shoes with a reverse heel and threetofour weeks following the surgery you may return to work provided your post-op condition was normal. However, you should consider wearing post-op shoes forsix to eight weeks after the procedure and expect some swelling of your foot;
  • Apply antioedematous medication and painkillers if necessary. Cold compress consisting of a dressing and an ice gel bag may sooth pain ailments and oedema throughout entire recovery time.

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Follow-up appointments:

  • 1 week following the procedure – wound healing control;
  • 2 weeks following the procedure – removing stitches, rehabilitation treatment;
  • 4 weeks following the procedure – control of the rehabilitation treatment process;
  • 6 weeks following the procedure – radiological control towards osteotomy adhesion progress and further recommendations concerning weight bearing as well as further rehabilitation.

Should you notice any distressing symptoms (acute pain, fever, persistent exudates from the post-op wound) do not hesitate to contact a doctor.

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Registration:

To have eligibility for the procedure to conducted in the Eskulap Hospital you are required to have an orthopaedic consultation with a specialist who will perform the procedure.

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Disclaimer:

This website describes standard aspects concerning your disease and treatment. It is not intended to replace professional medical treatment or talk between you and your orthopaedic specialist about your disease, treatment or operation.

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