Hallux Valgus – the painful bunion deformity

Bunion deformity – Hallux Valgus

Initially it appears to be a simple cosmetic problem when the great toe starts to move towards the other toes of the foot. However, the bunion deformity very soon becomes extremely painful and during its further evolution it has an influence on the lesser toes, and results in a painful complex forefoot deformity. At this stage the only solution for the patient is a surgical correction of the forefoot.

The human foot is an impressive construction by nature. It consists of 26 bones, 33 joints, muscles, tendons and over 100 ligaments. We make an average of 15,000 steps per day with it. Our feet can absorb this tremendous impact only because the weight of our body is being distributed on a larger area, with the help of muscles and the fat pad tissue in the sole of the foot. The construction of the arches in the feet plays a key role in this process. The ankle joint connects the foot with the lower limb and therefore has an important influence on the static mechanism of the entire body. Any malposition in the foot area can have a negative effect on the pelvis and the posture of the spine. The sole of the foot also works as a sensitive organ of touch, provided by a large network of sensitive nerves, during every step it continuously sends information to our brain.

The role that our foot plays in the function of our body is generally under estimated, most of us only become aware of our feet after we begin to have problems with them. Any pain, limitation of movement, change of posture, skin characteristics or colour are signs of a disorder in the highly complex anatomical construction of the foot.

The most frequent forefoot deformity is the bunion deformity, or in technical terms, Hallux Valgus. It requires a sensitive patient examination through a highly trained specialist to define in detail the cause and further consequences in the evolution of this deformity and the pain mechanism.

A great amount of pain caused by forefoot deformities such as bunions can be positively influenced, or even completely treated, with the help of custom made insoles, change of foot wear and correct physiotherapy. However, from a certain point on, especially when the lesser toes are already involved in the process of deformity, only surgery can offer a definite solution.

Exclusively in the forefoot area over 130 surgical techniques are described!

This shows the importance of this area and how frequently this bunion deformity occurs amongst the population. In modern foot surgery we prefer surgical procedures that maintain the existing joints, if possible, and due to the unlimited variety of forefoot deformities, every patient has to be treated with an “a la carte surgery” to reconstruct the individual forefoot problem. The preferred implant material is titanium and in the FSC Marbella we also have good experience with bioresorbable implants .

Post surgical treatment for a bunion obviously depends on the performed surgical procedures but, in general, the bone healing process takes 6 weeks. During this period we allow our patients partial weight bearing with the help of special shoes or orthotics. In our clinic we do not apply plaster any more, as we use only the latest more advanced material that has replaced it. Usually after 6 weeks normal gait with full weight bearing in comfortable shoes is allowed and full sports activities can be performed 3 months after surgery.

Dr Petr Spurek

Dr. Spurek is a well respected specialist in Orthopaedic surgery and Traumatology, a Certified Foot and Ankle Surgeon and specialist for Sports Medicine. He is the head of department for foot and ankle surgery at Xanit Hospital in Benalmadena and the Medical Director of the Marbella Foot and Sports Clinic. A keen sportsman, Dr Spurek has represented his native Czech Republic at both windsurfing and squash. A much sought after lecturer and teacher, Dr Spurek has taught at many Universities and hospitals throughout Europe. His clinic offers a total medical service for his patients, from a thorough initial diagnosis, to surgery if necessary, and complete post treatment rehabilitation.

www.fscmarbella.com