Lésions du pied (orthopédie)

Hallux (= big toe) valgus (= position of the toe inward).

This happens, among other things, due to laxity of the ligaments, usually in women (at least twice as much as in men). This can be congenital (familial) or caused by wearing narrow shoes too often. People with flat feet are also more likely to have hallux valgus.

Because the big toe comes in, there is irritation and friction in the shoe and extra bone is created on the side (= bunion or painful lump).

The deviation of the big toe is initially stopped by the second toe. After some time, this one is also pushed away (upward or downward) and the toes start to cross each other.

The most frequent complaint is a painful bunion or lump as it rubs in the shoe. Finding comfortable footwear is therefore not easy.

Sometimes the entire joint becomes inflamed, causing swelling and redness.

A hallux valgus is a progressive deformity and develops over years. Nevertheless, we also see very young people with such a deformity. It is then mostly a familial condition.

A hallux rigidus is a painful osteoarthritis in the big toe. Wear and tear of the cartilage causes narrowing of the joint (= osteoarthritis). This causes a painful restriction of movement. Bone is sometimes added to the side and top of the joint, creating a painful bunion or lump. In hallux rigidus, this lump is usually at the top.

Some people have  regular inflammation of the joint due to osteoarthritis.

The treatment at first is often conservative, for example: wearing wide shoes, a good firm sole ...

If this does not help sufficiently, surgery may be planned.

A hammertoe/clawtoe is a bent position of the toe, usually of the second or third toe, which eventually creates pressure and friction against the footwear.

With a hammertoe, the deformity occurs in the first toe-joint; with a claw toe, it usually occurs in both toe-joints. This condition can still be flexible or already stiff.

With some foot shapes (hollow feet), this is more common.

Sometimes the second toe is forced into a hammer position by a severe hallux valgus and correction of the second toe is not enough, but the big toe must also be corrected to give the second toe room.

Most patients suffer on the upper side of the toe (friction and calluses), sometimes also on the lower side at the level of the tip of the toe. Sometimes wounds develop, and even infection of the joints is possible.

A supple hammertoe can be corrected with orthotics or an orthotic.

A stiff hammertoe can only be treated surgically.

A common problem is pain at the bottom of the forefoot, under the pads , just in front of the toes. This is called metatarsalgia and can have several causes.

Most often this is a sagging forefoot and you have calluses or pain from inflammation of the joints. Sometimes the pain is caused by entrapment of the nerve between the joints, we call this Morton neurinoma but it is not very common.

Occasionally we see on the radiography that the metatarsal bones are much too long and in this way become overloaded. Usually an arch support is sufficient, but sometimes we have to shorten these bones surgically.

Tailor's Bunion is a lump on the outside of the little toe. It is often painful and red due to friction in the shoe. Usually the patient has a wide foot (spread foot).

The treatment of choice is wide shoes, possibly an orthotic or, if this fails, surgical treatment.