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What’s hallux varus?

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Hallux varus is a condition where the big toe points inward, causing difficulty walking and wearing shoes. It can be caused by birth defects, injury, or bunion surgery. Treatment depends on the severity, with surgery being necessary for most cases. Symptoms include pain, tenderness, and weakness. Corrective procedures are effective, with most people returning to normal activity within six months.

Hallux varus is a condition in which the big toe points inward, away from the other toes. The deformity can be caused by a birth defect, an injury to the foot, or as a complication of bunion surgery. A person who has hallux varus is likely to experience difficulty walking and wearing shoes, tenderness, and slight swelling. Treatment for the condition depends on the severity of the symptoms and how out of alignment the big toe is. Splints and stretching exercises may be able to correct minor deformities, but most cases require surgical realignment.

When hallux varus affects an infant or child, the cause is usually a birth defect of the toe bones or local tendon called the abductor hallucis. An especially small or tight abductor hallucis can pull the big toe away from the second toe, causing it to point towards the other foot. An elderly patient may be suffering from hallux varus due to an acute injury or a chronic condition such as rheumatoid arthritis. Also, surgery to correct a bunion can cause hallux varus if too much bone or tendon tissue is removed. In some cases, the toes gradually move further and further out of alignment with no discernible cause.

In addition to the obvious visible deformity, hallux varus symptoms can include chronic pain, tenderness, decreased mobility, and weakness in the foot. Some people find it difficult to wear closed shoes and to balance when walking or standing. If the condition is not addressed and treated, constant pressure on the toe can lead to swelling and pain radiating throughout the foot and ankle.

A person suffering from bunions should make an appointment with their podiatrist or primary care physician. A doctor can inspect the toe and take x-rays to determine the extent of internal damage. When the misalignment is relatively minor, a podiatrist will usually suggest nonsurgical corrective procedures such as wearing a toe splint at night and investing in comfortable shoes. Young patients who are suspected to have tight hallucis tendons are candidates for guided stretching exercises, which involve gentle toe pulling in different directions to loosen the tendons over time.

Surgery is typically needed if the condition persists or causes severe pain. A surgeon can manually force the alignment of the toe, scrape away damaged bone and cartilage tissue, and ensure that nearby tendons are secure. A patient may need to wear a special cast or shoe for several weeks after surgery to give the toe time to heal. Corrective procedures are usually very effective, and most people are able to return to normal activity within six months.

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