Hallux Valgus / Hallux Varus

Hallux valgus, commonly known as a bunion, is a foot deformity where the big toe turns inward (medially) and the joint at its base protrudes outward, forming a bony bump.


Hallux Valgus (Bunion):

Deformity where the big toe deviates outward (towards the other toes), causing a bony bump at the base of the toe.

Hallux Varus:

Opposite deformity where the big toe deviates inward (away from other toes).

Causes

  • Genetic predisposition (family history).
  • Wearing tight, narrow, or high-heeled shoes.
  • Flat feet or abnormal foot mechanics.
  • Arthritis (especially rheumatoid arthritis).
  • Trauma or previous surgery (e.g., overcorrection after bunion surgery).
  • Neuromuscular conditions (can contribute to hallux varus).

Symptoms

  • Visible deformity (toe angling outward in valgus, inward in varus).
  • Pain and tenderness at the base of the big toe.
  • Swelling, redness, and inflammation around the joint.
  • Corns, calluses, or skin irritation from rubbing in shoes.
  • Restricted movement and stiffness of the big toe.
  • Difficulty wearing normal shoes and walking comfortably.

Treatments

Conservative (Non-surgical):

  • Proper footwear: wide toe box, soft insoles, avoid high heels.
  • Toe spacers or splints to reduce friction and realign toes (especially early stage).
  • Orthotics (shoe inserts) to correct abnormal mechanics.
  • Pain relief: NSAIDs, ice packs, padding.
  • Exercises: toe stretches, strengthening foot muscles.

Surgical (for severe deformity or persistent pain):

  • Bunionectomy (for valgus): removing bony prominence and realigning toe.
  • Osteotomy: cutting and repositioning the bone.
  • Arthrodesis (fusion): fusing the joint in correct alignment (used in severe arthritis).
  • Soft tissue procedures: tendon balancing to correct alignment.