For God’s sake, the sneakers are beautiful and comfortable, and now they go with everything. But we want to put a pair of Blahinks? However, because of the big toe, sandals and stilettos remain in the shoe rack. Y every time they try to put on they are painful. Even strong. because at some point the big toe has become more and more like an onion? And above all, is there any exercise to do or other solutions, perhaps definitive? A super-experienced surgeon of all those little bones that make up the ankles, heels, tarsus, and metatarsus answers these and other questions, Dr. Federico Usuelli, head of Ankle and Foot Orthopedics at Humanitas San Pio X in Milan.
What is hallux valgus?
Hallux valgus is not just a cosmetic problem. It’s a joint deformation and as such it must be evaluated and treated by a specialized surgeon. “This deformation causes a lateral deviation of the big toe towards the other toes, with the formation of a ‘bump’ at the base of the toe, which can cause shoe conflict. In its evolution, the big toe can even reach lean toward the other fingers to the point of “going under” explains Dr. Federico Usuelli. We mere mortals say that an “onion” forms on the side of the index finger because in fact there is also a “swelling” of the soft tissues of the foot. Sometimes due to the inflammation, a true bursitis can be created and then nothing more than high heels or pointy-toed shoes.
It’s all Grandma’s fault.
It is often thought that hallux valgus blame the high heels worn from morning to night, or in shoes so tight that by dint of compressing the tip of the foot, the big toe has sprained. «Ladies can rest easy, it is not their fault if hallux valgus appears. Of course, some habits can make it worse, but this deformation is due to a certain familiarity”, clarifies Dr. Usuelli. So if your grandmother had it, there’s a good chance you have it too. Also, some activities, such as dancing on pointe, have little effect on this issue. As a famous doctor from the New York City Ballet said: “If you have hallux valgus, take it out on your grandmother, not with dancing or with your shoes”.
Yet another female-only issue?
It is true, hallux valgus affects girls and women more, but men (for once) are not spared either. “Frequently It is believed to be an exclusive problem for women. and in fact, the bunion is the number one cause of foot surgeries in women, but for him, it is the second cause, so even the male is often forced to undergo surgery for this deformity» explains Dr. Federico Usuelli.
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When is the time to have a hallux valgus operation?
“I generally recommend surgery when they occur at least two of these three conditions» clarifies Dr. Usuelli. “When really I don’t like to see my foot with a crooked toe When hurts The when prevents you from wearing shoes you want» concludes Dr. Usuelli. And not just ankle boots or sandals, but also any type of open shoe, because the latter may not bother the foot, but seeing that “onion” on the first toe leaves no one indifferent.
The most used technique…
The way to operate hallux valgus has changed a lot in recent years. Now we mainly use minimally invasive or percutaneous surgery which enables eliminating deformation without having to make large cuts or engravings. «It is not only an aesthetic question: the absence of incisions means respecting the soft tissues. And the function of the foot, which is first and foremost a sensory organ, even before movement”, explains Dr. Usuelli. “The percutaneous technique is also called laser surgery, but the laser has nothing to do with it. It’s usedOf course, a small “cutter”. Very similar to those of dentists, which are inserted with “small holes” in the bone. Through this, skeletal corrections are made”, concludes Dr. Usuelli.
Do you need anesthesia?
A local anesthetic is sufficient, but sedation is used only for particularly anxious patients. However, this technique has a limit: hallux valgus can only be partially corrected because the foot is bandaged after the operation and it is not said that the big toe bone will stay straight forever. The good news is that today the percutaneous technique has evolved which fixed this problem.
… and the one that never makes hallux valgus come back
“The evolution of the percutaneous technique is called MICA, which stands for Minimally Invasive Chevron Akin. “With this method, the skeletal correction is stabilized with a mini titanium implant which keeps the correct bone in the ideal position until healing occurs”, the surgeon clarifies. In this way the bone heals in the correct position and the hallux valgus will not reform. Not only that, the MICA technique allows you to intervene even when the “onion” is very large. In 98% of women, the titanium miniprosthesis does not cause problems. What about the other 2%? “If you really feel discomfort, once the bone has stabilized, the mini-implant can also be removed,” explains Dr. Federico Usuelli.
The surgery takes only 20 minutes.
The MICA technique is not a laugh method! It not only works even when the operating difficulty is greater and allows correct 90% of cases the operation is very short and has an average duration of 20 minutes to a maximum of half an hour. It can be applied to both men and women and is performed under local anesthesia from the ankle down. It is performed in a day hospital, so they come home in the afternoon wearing a nice pair of tennis-type shoes. “For about a month you have to wear these shoes that you can wear to carry out normal daily activities except sports. Several days are needed to return to running or to wear shoes with very narrow toes”, clarifies Dr. Federico Usuelli. In short, Louboutin can wait… but only three months.
Who can practice it
To perform the MICA technique, the doctor must make any specific training. “For this reason, every year my group organizes an Academy dedicated to the training of surgeons in this and other topics (Foot and Ankle Academy) in collaboration with the Humanitas University”, clarifies Dr. Federico Usuelli.