【Health Lecture】Take you to easily understand the knowledge of hallux valgus

In order to ensure the scientific effect of learning health knowledge in the "2024 China Senior Health Knowledge Competition", the organizer has collected various health science articles suitable for the elderly from various hospitals. We will share them through the "Health Lecture" column. Today, Director Zhang Mingzhu of Beijing Tongren Hospital "Takes You to Easily Learn About Hallux Valgus Knowledge", and welcomes elderly friends to learn. Shoes are indispensable items in our lives, but many people have a small protrusion on their feet and cannot wear shoes comfortably. Today, I will introduce to you a more common foot deformity-hallus valgus.

Hallux valgus

What is hallux valgus?

Hallux valgus is also known as "big foot bone" or "big goblet crutch". Hallux valgus is the official name in English, and bunion also refers to hallux valgus.

Hallux valgus is one of the most common foot diseases, and is the most common disease of the big toe. The big toe deviates outward, and the angle between the proximal phalanx of the big toe and the first metatarsal bone is greater than 15 degrees. Hallux valgus is common in women, and according to statistics, the ratio of female to male is about 15:1.

Traditionally, foot and ankle surgery professionals may refer to all diseases related to "hallux valgus" as hallux valgus, but in fact there are far more than just hallux valgus.

In addition to the outward deviation of the big toe, hallux valgus may also cause deformity and pain in the second or third toe, painful calluses under the second toe, etc.

Common types

1. In clinical work, the most common type of patients are female patients around 50 years old, who have long-term hallux valgus deformity and uneven degeneration of articular cartilage, which leads to arthritis of the first metatarsophalangeal joint and joint pain. Or they come to see a doctor for pain and dislocation of the second toe or pain and dislocation of the fifth toe caused by the compression of the big toe outward.

2. Another type of patients has cerebrovascular disease or neuromuscular disease, which causes imbalance of foot muscle strength, resulting in hallux valgus deformity, usually accompanied by abnormal muscle tension and abnormal gait of lower limbs. They usually have a history of cerebrovascular disease, hypertension, coronary heart disease or cervical spine disease.

3. Another type is hallux valgus in adolescents, which usually occurs in children under 18 years old. The first metatarsal bone is adducted before development, and the big toe is valgus, accompanied by obvious dislocation of the sesamoid bones of the metatarsophalangeal joint. During development, the joint surface develops to an inclined angle, and the deformity is difficult to correct.

Most of these patients seek medical treatment before the age of 30. Because they need to wear formal shoes after work, the friction between the foot joints and shoes increases, causing pain and redness and swelling.

4. A considerable number of men also have hallux valgus, but men usually wear loose shoes, so it is less likely to cause pain and discomfort. Only when the second toe is squeezed, deformed and painful will they seek medical help.

What problems does hallux valgus cause ?

The most common problems caused by hallux valgus include pain and difficulty wearing shoes. In severe cases, it can also cause arthritis and degenerative changes in the metatarsophalangeal joint of the big toe; it can also cause deformity and dislocation of the second toe.

>> Pain

The pain of hallux valgus is usually located in the bunion, and some patients also experience redness and swelling of the skin and soft tissue. It often eases after rest or by changing to loose sneakers or slippers.

>> Difficulty putting on shoes

Difficulty in wearing shoes is another major problem of hallux valgus deformity. Due to the deformity of the big toe, it may be impossible to wear any commercially available shoes. The huge protrusion on the inside of the foot will cause severe pain, redness, swelling and soreness after walking a lot every day.

Over time, due to differences in shoe wearing habits, hallux valgus can cause pain under the second metatarsal bone and form calluses , or calluses. Many patients need to frequently thin the calluses on the soles of their feet to relieve pain.

When the big toe is squeezed, the second toe will be lifted up , which will gradually cause joint stiffness and pain, forming a crossed toe or hammer toe deformity.

These are related to biomechanical changes in the foot. Normally, the weight under the big toe of the forefoot is 50% of the body weight, and the weight under the outer four toes is 50%. When hallux valgus occurs, the weight under the first metatarsal bone decreases by 20%-30%, and then transfers to the second and third metatarsal bones on the outside, causing metatarsalgia.

Hallux valgus increases the width of the foot, and some patients may develop calluses and pain on the outside of the fifth toe. Sometimes patients come to the doctor because of excessive pain on the outside, but at this time, we should also consider whether the deformity of the first metatarsal needs to be corrected at the same time.

This article introduces hallux valgus and its effects. The next article will introduce how to deal with the pain caused by hallux valgus and other scientific knowledge such as correction. Please stay tuned! About the Author

Zhang Mingzhu is the director of the Foot and Ankle Surgery Center of Beijing Tongren Hospital affiliated to Capital Medical University, a professor, chief physician, doctoral supervisor, one of Beijing's top talents, and has presided over three National Natural Science Foundation projects and nine provincial and ministerial projects. He has published 32 SCI papers, 11 of which have an IF score greater than 10.
Social Positions:

Secretary General of the Chinese Foot and Ankle Medical Training Project Expert Committee

Vice Chairman of SICOT Chinese Foot and Ankle Surgery Committee

Vice Chairman and Secretary General of Foot and Ankle Committee of Chinese Society of Research Hospitals

Deputy Chairman of the Foot and Ankle Surgery Committee of the Bethune Foundation

Member of the Foot and Ankle Basics and Orthopedics Group of the Orthopedic Branch of the Chinese Medical Doctor Association

Secretary-General of Foot and Ankle Committee of Orthopedics Branch of Chinese Association of Integrated Traditional Chinese and Western Medicine

Editorial Director of Electronic Journal of Foot and Ankle Surgery

Editorial board member of Foot & Ankle International, Injury and other magazines