Your contact partners
in this area:
Prof. <br /> Dr. med. habil.<br /> Georg Matziolis
Dr. med. habil.
Georg Matziolis

Senior Consultant of the Clinic for Orthopaedics and Accident Surgery

Acting holder of the Chair for Orthopaedics of the FSU Jena at the Waldkrankenhaus Eisenberg

036691 8-1002

Specialist Registrar Dr. med. Andreas Wagner
Specialist Registrar Dr. med. Andreas Wagner

Head of department hand and foot surgery

Specialist for Orthopaedics and Accident Surgery, Rheumatology, Hand Surgery, Special Orthopaedic Surgery, Physical Therapy and Chirotherapy.

Hallux valgus

The hallux valgus (bunion) is the most frequent large toe malposition: The big toe turns to varying degrees towards the small toe side and the ball of the big toe protrudes to the side. On the inside of the ball, increased friction and additional pressure on the soft tissue is caused when wearing shoes. This may progress as far as the formation of painful synovial bursae (fluid-filled sacs).

Depending on the extent of the malposition, the large toe may rub against the adjacent second toe and lead to painful calluses here. The small toe may also be pushed upwards, which promotes the development of claw toes or mallet toes.

The causes of hallux valgus are varied: Innate changes, considerable loads and a muscle-ligament weakness may be the cause. It is also to be assumed that years of wearing the wrong shoes (high heels, narrow shoe tips) promotes the development of hallux valgus.

There is no origin-based conservative treatment for hallux valgus. To alleviate complaints above the painful ball, sufficiently wide or open-toed shoes are recommended. Toe-spreaders can be helpful if the painful contact been the big and small toes is of primary importance. A correction of position can no longer be achieved in adulthood with bandages or postural splints.

Permanent positional correction of the large toe can only be achieved with an operation: Depending on the extent of the malposition, the age of the patient, the functional requirements and possible concomitant disorders, various operative methods are available. The hallux valgus operation is based on axial correction of the first metatarsal ray, which is supplemented by suitable soft tissue measures on the metatarsophalangeal joint of the big toe.

Using modern operating methods and stable fixing procedures, it is possible to subject the foot to loads again in special shoes immediately after the operation. Plaster casts are therefore a thing of the past. Consistent elevation of the foot, movement exercises and physiotherapy (cryotherapy, lymphatic drainage) reduce the swelling of the forefoot and accelerate the recovery process.

Small toe deformities

Small toe deformities can occur in all joints. This may be caused by a muscle imbalance, a hereditary overlength of the small toe, an accompanying hallux valgus malpositioning and unsuitable shoes.

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