What is hallux valgus and what causes hallux valgus?

Hallux valgus is a common foot disease in recent years, usually in the early stage of the instep of the foot bony protrusion, in the later stage it may be difficult to walk. Hallux valgus appears in adolescence, and it is recommended that it can be corrected with orthotics and good living habits, but it is best to use surgery to appear in middle and old age**, and you should also pay attention to recovery after surgery, and do not wear too hard shoes.

This situation is very common, there are many people with this situation, generally women have this situation more, there are also men who have this situation, this situation must be dealt with in time, otherwise, it will become more and more serious, and it will seriously affect the appearance, especially in summer, wearing sandals is ugly.

Beijing Shengjiaxin Medical Aesthetic Hospital-Plastic Surgery-Deputy Chief Physician-Qiu Lidong-Does a natural hallux valgus need **.

Hallux valgus is a common bone problem in the foot that is related to a variety of factors.

There are two main reasons: on the one hand, there are genetic factors, which often occur before the age of 20; On the other hand, there is the reason for wearing shoes, wearing pointed-toe shoes or high heels is the external cause of hallux valgus.

In addition to the above factors, structural abnormalities of the foot (flat feet, pronation of the hallux, muscle tone imbalance, etc.), rheumatic diseases, neuromuscular lesions, trauma, etc. can also lead to the occurrence of hallux valgus.

1. Genetic factors, hallux valgus is a disease with a strong genetic tendency, and heredity is mainly maternally inherited, that is to say, it is passed from grandma and grandma to the next generation. However, there is no correlation between the severity of hallux valgus and the genetic generation, grandmothers and grandmothers may be more severe, but offspring hallux valgus may be milder;

2. The second type of reason for hallux valgus is external causes, mainly related to wearing shoes, sometimes wearing shoes that are too tight in front or lesbians like to wear high heels, because the space in front of the shoes is relatively narrow, and the five toes will be squeezed together, so that the hallux valgus will be caused by external forces, and the development of hallux valgus will be aggravated after a long time;

3. Combined with other diseases caused by hallux valgus, such as more serious flat foot syndrome and rheumatoid arthritis, because of the joint posture or the destruction of the joint by rheumatoid arthritis, the soft tissue imbalance will occur, so the deformity of the first metatarsophalangeal joint will occur, and then hallux valgus will occur.

Sun Yehui, director of the hallux valgus department of Beijing Huatan Hospital, introduced: The cause of hallux valgus is not clear, and it is generally believed to be related to a variety of factors. The two main points:

On the one hand, there are genetic factors, many patients have a family history, often before the age of 20 hallux valgus; On the other hand, there is the reason for wearing shoes, wearing pointed-toe shoes or high heels is the external cause of hallux valgus. In addition to the above factors, structural abnormalities of the foot (such as flat feet, hallux pronation, muscle tone imbalance, etc.), rheumatic diseases, neuromuscular lesions, trauma, etc. can also lead to hallux valgus. The cause of the basic hallux valgus is not well understood, but it is mainly thought to be related to abnormal foot anatomy and plantar fascia and muscle tone imbalance.

Genetic factorsGenetics is an important factor in the development of hallux valgus, especially in adolescents. Poor shoe habits include wearing high heels, pointed-toe shoes, etc., where the front of the foot is squeezed into a narrow triangular area, and the stiff upper can force the hallux to valgus. In particular, walking and exercising for a long time while wearing inappropriate shoes or pointed and thin heels can easily lead to the disease.

Congenital structural abnormalities of the foot due to congenital factors such as flat feet, hallux pronation, and muscle tone imbalance can lead to hallux valgus. Among them, flat foot deformity can cause fascial and muscle tone imbalance, resulting in the instability of the first metatarsophalangeal joint, and eventually hallux valgus. With the increase of age, the stability of the plantar muscles and fascia decreases, which is easy to induce hallux valgus.

Other factors: Various inflammatory diseases such as rheumatoid arthritis cause bone destruction in the feet, which can easily lead to hallux valgus. First metatarsal varus, in which the first metatarsal bone turns inward at the metatarsal wedge joint, may also be a cause of hallux valgus. In addition, trauma to the joints can also lead to hallux valgus.

(1) The cause of the disease.

1.The occurrence of hereditary hallux valgus malformation is related to congenital factors, and genetic factors are present in about half of cases. Lake believes that the first metatarsal varus is the main cause of the deformity.

Clinically, many patients have a narrow medial wedge shape in the first cuneiform bone, resulting in an inward tilt of the metatarsophalangeal joint. However, in the author's group of 76 foot hallux valgus, only 9 feet had the first metatarsal varus more than 12°. According to Carr's standard, the angle of the metatarsal bone is 9°, and only a small percentage exceeds this standard, indicating that plantar varus is not congenital.

In 11 of these 76 feet, the angle of the metatarsal bone decreased by 2° to 4° after MCBRIDE, apparently due to the reduction of the bowstring action of the extensor pollicis and flexor pollicis muscles after hallux valgus correction, as well as the transfer of the adductor muscle to the first metatarsal. At the same time, after hallux valgus, the bowstring-like action of the muscles will produce the force of pushing the metatarsal bones inward.

2.Wearing high-heeled pointed-toe shoes is one of the main factors in the formation of hallux valgus, the front of pointed-toe shoes is triangular, when standing on high heels, the front of the foot is tucked into a narrow triangular area, the stiff upper forces the hallux to valgus and slightly externally rotated, the little toe is inverted and slightly internalized, the proximal interphalangeal joint of the middle 3 toes is strongly flexed, and the metatarsophalangeal joint and the distal interdigital joint are over-extended.

3.Various inflammations, especially rheumatoid, often result in outward subluxation due to joint destruction, resulting in hallux valgus deformity.

ii) Pathogenesis.

Due to tension and traction of the extensor pollicis longus, flexor pollicis longus, and adductor pollicis muscles, the hallux externally rotates the valgus toenail along its long axis toward the midline and continues to worsen. In the medial abductor pollicis and flexor pollicis brevis medial head and its internal sesamoid bone are displaced outward, losing abduction, and then the lateral head contracture of the adductor pollicis and flexor pollicis brevis muscle on the lateral side, the contracture and thickening of the lateral capsule, the outward subluxation of the hallux, the lateral sesamoid enlargement, moving between the metatarsal heads, the hallux valgus pushes the first metatarsal inward, widens the transverse arch of the foot, and the medial side of the metatarsal head is squeezed and rubbed by the upper, bunions occur, pain, and then the first metatarsal head becomes enlarged, forming an osteophyte protruding medially. Due to the tension and strain of the adductor pollicis muscle, the transverse arch of the foot is flattened, the metatarsal head collapses to the lateral end of the plantar side, and the weight-bearing and friction cause the thickening of the place to form the callosum.

The hallux is turned outward, the second toe is squeezed, the position of the second toe is occupied, and the second toe is lifted to overlap the hallux, so that the metatarsophalangeal joint of the second toe is hyperextended, and the proximal interphalangeal joint is flexed to become a hammer-shaped toe, which protrudes from the dorsal side of the hallux and the third toe, and the dorsal side of the proximal interphalangeal joint is rubbed and squeezed by the upper of the shoe, which also produces callosome pain.

The hallometatarsophalangeal joint is in a subluxated position, and under the action of abnormal stress for a long time, osteoarthritis gradually appears, the joint space narrows, and the bone becomes hard and more painful.

The pathological changes of hallux valgus can be summarized as follows: hallux valgus, metatarsophalangeal subluxation; 1st plantar varus, bunions; callosum at the first metatarsal head; 2nd toe hammer-shaped; Osteoarthritis of the 1st metatarsophalangeal joint.

About half of the patients have a genetic cause.

The main reason for the occurrence of hallux valgus is due to certain defects in the bones and ligaments that make up the foot.

Secondly, standing and walking for a long time can also increase ligament damage, promote the onset of the disease or accelerate the progression of the disease.

Again, pointed-toe shoes or high heels are often worn, the front of the pointed-toe shoes is triangular in shape, forcing the front of the foot to be tucked into a narrow triangular area, and the leather of the upper is not elastic, forcing the hallux toe to turn out and the little toe to turn in. High heels increase the pressure on the foot, and the ligaments in the joints are overstretched, causing the thumb to turn out.

Thumb valgus may be caused by congenital bone dysplasia, or it may be caused by trauma, generally more congenital, of course, poor recovery from fracture after trauma or severe nerve damage can lead to thumb valgus.

Many factors are related to this, but the theory of Chinese medicine believes that there are only two reasons that are the most related, the first is caused by genetic factors, and the second reason is caused by improper wearing of shoes, that is, acquired reasons.

Congenital genetic factors, or women wear high heels for a long time, or walk a lot and often, or wear small shoes to squeeze their feet, or toe toes, etc.

Wearing high heels is one of the causes of hallux valgus. Especially if you wear those kind of shoes that are so tall for a long time!

Causes of hallux valgus: 1. Genetic factors: About half of the patients have genetic factors.

Although the occurrence of hallux valgus is related to the inappropriate shoes, it is mainly caused by some defects in the bones and ligaments that make up the foot. 2. Standing and walking for a long time will aggravate ligament injury, promote the onset of the disease or accelerate the development of the disease.

3. Often wear pointed-toe shoes or high heels: the front of pointed-toe shoes is triangular, forcing the front of the foot to be tucked into a narrow triangular area, plus the upper is leather without elasticity, the big toe is forced to turn out, and the little toe is turned inward. The high heels increase the pressure on the feet, and the ligaments at the joints are overstretched, resulting in the hallux valgus.

The causes of hallux valgus can be divided into two categories: congenital factors and acquired factors. Congenital factors are caused by joints, nerves, muscles, etc.

For example, flat feet, genetics and the reduction and imbalance of plantar tendon strength reduce the plantar function, resulting in instability and deformation. The acquired factor is caused by wearing shoes that do not fit well, usually because the heel is too high, too sharp and too narrow shoes, so that the heel is not easy to fix, causing squeezing friction and compression to the toes, which not only affects the extension and activity of the toes, causing discomfort and pain, but also destroys the function of the original three footholds, and when walking, the whole body weight falls on the front end of the foot, and the toes will gradually deform due to the weight pressure of the body, which will cause the phenomenon of hallux valgus.

Valgus is a common foot deformity that occurs mainly at the location of the large female toe.

Experts said that in recent years, the incidence of hallux valgus has been increasing, and everyone should do a good job in prevention, especially women, and the premise of prevention is undoubtedly to understand the best in order to carry out effective prevention.

The following is the best orthopedic hospital in Shandong - Shandong Hand and Foot Surgery Hospital, Director Lu Kaiyi, an expert in hallux valgus diagnosis and treatment, will introduce you with detailed information about hallux valgus**, I hope it can be helpful to you.

Reason 1 for hallux valgus:

Reason 2 for hallux valgus:

Rheumatoid In patients with rheumatoid disease, it can be found that many patients are accompanied by hallux valgus, so rheumatoid is also a cause of hallux valgus.

Reason for hallux valgus three:

Wear high-heeled pointed-toe shoes.

High heels have long been considered an important factor in hallux valgus, and experts have never denied this view, as high-heeled pointed-toe shoes can squeeze the foot into a triangle when standing, leaving the toes in an uncomfortable state, which can easily induce hallux valgus.

It is generally believed to be related to a variety of factors, the most important of which are two:

On the one hand, there are genetic factors, many patients have a family history, often before the age of 20 hallux valgus;

On the other hand, there is the reason for wearing shoes, wearing pointed-toe shoes, or high heels is caused.