There are a lot of techniques to correct the hallux valgus. How to choose the right one?

Hallux valgus is a deformity of the first-foot toe which results laterally deflected. Sometimes, according to the deformity seriousness, it can also be linked to mallet fingers due to its lateral curvature and the pressure applied on those ones.

Not uncommonly, this bone deformity can be associated with a progressive inflammation and a degeneration of the surrounding soft tissues, which sometimes can cause acute bursitis, leading to local ulceration and infections.

In the popular imagination, the hallux valgus is associated to the use of improper shoes. But more frequently, instead, is linked to other pathologies or foot deformities such as the pronation syndrome (flat foot), neurological peripheral deficits and systemic diseases (rheumatoid arthritis).

Hallux Valgus: mini-invasive surgical treatment

When an intervention becomes necessary, the mini-invasive surgery can be applied. Thanks to this technique, it is possible to reduce the pain, the bleeding, the post-operative swelling and to accelerate the recovery, by minimising the cutaneous incisions and the soft tissue dissection.

This treatment has been developed thanks to very reduced incisions, in other words dotted, and to cutters connected to microengines, similar to those used by dentists.

This technique choice, which has already become reliable and reproducible, has to be well-evaluated by a specialist, though. This, according to the hallux deformity seriousness and the presence of associated deformities such as the hindfoot ones which, if ignored, can lead to not so optimal results, or to the mini-invasive surgery failure.

Surgical treatment of hallux valgus

In the case that the mini-invasive technique is not available, other valid techniques can still be resorted to. The surgery aim is to obtain a functionally efficient foot again, also aesthetically satisfying.

There are a lot of techniques to correct the different degrees of hallux valgus. First of all, as said before, a very delicate question concerns distinguishing an isolated deformity from a syndrome-related deformity. In the last case, it is fundamental to correct every single foot malfunctioning, and not only the hallux valgus.

For this reason, when the mini-invasive technique is not practicable, I often happen to suggest the BOAT technique (Best Of All Techniques): a technique which gathers the best of all the osteotomies which have been proposed throughout the years.

The first surgeon who suggested it was Dr. Chris Coetzee, a South African colleague who works in Minneapolis and I had the chance to personally work with, by learning a few “tricks” of these techniques which I always apply today to the benefit of my patients. The BOAT associates the versatility of the traditional “distal chevron osteotomy” (best known in Italy as “Austin”), with the “Scarf” stability (more popular in France), so that the patient can perform the immediate loading thanks to particular post-operative flat shoes, and not to old “Talus” shoes, responsible for a lot of knee and ankle problems.

To find out more about the topic, please visit the hallux valgus webpage.