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Patricia asked...

Bilateral hallux valgus

Can you give me any information on the op. for bilateral hallux valgus. I am 71 years old. I cannot find much info on this I would like to know what the op entails. Thanks

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The answer

The problem is deviation of the great toe so as to put a valgus deformity on the first metatarsophalangeal (MTP) joint. A deviation of 15-20° is considered abnormal. This deviation upsets the movement within the foot. It may cause subluxation of the first MTP joint and the great toe may even overlap the second toe. Lateral subluxation produces a prominence on the metatarsal head (bunion) often followed by the development of a fluid-filled bursa. This becomes painful as it rubs against the shoe.

There are a large number of surgical options and the choice of procedure will depend upon the precise nature of the problem. It is usually a combination of bone and soft tissue surgery. The simplest is the removal of the bony prominence (exostectomy). Alternatively, Keller's arthroplasty involves creating a flexible joint by excision of the medial eminence of the metatarsal head together with some of the proximal phalanx. Replacement of the joint for hallux valgus is a more recent option.

The National Institute for Health and Care Excellence (NICE) has given the procedure a cautious welcome. Arthroscopy is rarely indicated in this joint and less invasive arthroscopic surgery is unlikely to be helpful for hallux valgus. NICE guidance on minimal access techniques acknowledges that less invasive techniques may be attractive to patients but need further evaluation. Hopefully this will help you.

Answered by Health at Hand nurses.


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