Hallux valgus is due to the medial deviation of the first metatarsal with the lateral deviation of the big toe or a prominence of the first metatarsal head.  It affects more than 35% of people over 65 years old. 

Risk factors

• Women are more likely to be affected with symptoms of pain
• Family history
• Rheumatoid arthritis
• Cerebral palsy
• Wearing shoes with high heels or narrow front

Symptoms

• pain over prominence at the 1st meta-phalangeal (MTP) joint
• difficulty with shoe wear due to medial protuberance
• compression of digital nerve causing pain or numbness

Click to view Orthopaedic World video on Hallux Valgus Surgery

Treatment Options

1. Conservative Treatment using taping, shoe modification with pads, spacers or orthotics.  However, surgery may be required if the symptoms have not improved with conservative measures or for cosmetic correction.

2. Surgery. A Scarf osteotomy is a procedure for hallux valgus and the term ‘scarf’ describes the shape of the bone cut (osteotomy).  This surgery has the advantage of allowing movements of the bone in a number of different planes. The procedure involves the release of the tight ligaments (lateral release) and tightening of the loose ligaments (medial plication) to balance the joint while making some cuts in the bone to reshape the foot.

Post Operative Care

• The foot is supported in a bandage for a few days
• Your sutures will be removed around 10-14 days
• You have to keep your weight off the front of the foot for up to 6 weeks by using crutches or a forefoot off-loading (reverse wedge) shoe
• The operated foot or feet will be swollen due to gravity pulling fluid down to the feet whenever you lower your feet especially when standing or walking.  Keeping the foot elevated whenever possible helps.  This phenomenon normally resolves after 4-6 months.

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