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HALLUX VALGUS (THUMB BONE PROTRUSION) IN 10 QUESTIONS
1- Hallux Valgus disease (toe and toe bone protrusion) is observed at a higher rate in women.
The exact Turkish version of Hallux Valgus disease means that the toe is bent outwards. This disease is popularly known as “decussation of the toes” or “bunion”. In this disease, the first toe of the foot makes a corner by bending the comb bone inwards and the thumb bone outwards, and the bone becomes protruding from the corner point. This disease usually starts at a very mild level at an early age, progressing over time to become more serious. When it exceeds a certain angle, it begins to cause symptoms that reduce the patient’s quality of life, cause pain, make it difficult to walk and wear shoes.
2- Are decals of silicone between the fingers therapeutic in hallux valgus disease?
A noticeable redness, swelling and inflammation are observed on the skin on the outer surface of the increasingly deformed thumb bone. People feel pain, soreness and numbness when wearing shoes and walking. Silicone devices can prevent and relieve the pressure of the shoe on the skin and the inflammation area for a short time, but this feeling of relief is temporary.
Silicones are not curative of the disease, they cannot correct the existing deformity (protrusion) in the bone in any way. Since it will narrow the area inside the shoe, they may also cause other fingers to be damaged by the shoe and other deformities to occur. Therefore, if the silicone devices in question are presented to patients with an emphasis on the bone corrective effect, they will harm rather than benefit patients by delaying the treatment of Hallux Valgus disease with the misperception that may occur.
3- What are the effects of Hallux Valgus on daily life?
The effects occur with the progression of the disease. The most important effect is that it seriously reduces the quality of life of patients. First of all, the quality of life begins to decrease with the formation of pain and redness on the edge of the toe. Later, patients have difficulty wearing shoes. Women have difficulty wearing high heels at first. But in the later stages, patients have difficulty wearing even normal sports shoes. As a result of this, patients feel a decrease in their mobility. They reduce the daily amount of energy burning. They can’t move very comfortably; they can’t walk and they can’t do sports properly. Because of this, even if they take a normal amount of their daily diet, their weight may start to increase because they have fewer calories to burn. Patients usually express it like this: ‘Doctor, I eat normally, there is no exaggeration, but I have started to gain weight, everything I eat works!’. Even if it is considered very unrelated in such cases, we should know that this pain in our foot can cause it. It should not be forgotten that in a passive life, we will get chronic diseases such as heart, blood pressure, diabetes much easier.
4- Is Hallux Valgus a common disease in our country?
Hallux Valgus is a very common disease all over the world, as it is in Turkey. “an 18-65 wound is a disorder that can be seen in 25 percent of adults. This disease is 4 to 7 times more common in women than in men. it is possible to see this disease in 6-7 women despite 1 man. It is believed that the reason for this is genetic factors, as well as the effect of women’s use of high-heeled, pointed and narrow shoes. Although this has not been scientifically proven, if we are predisposed to this disease and we wear these shoes too often, the likelihood of getting this disease increases. After the age of 65, the incidence of the disease increases up to 35 percent. 35 out of every 100 people in society over the age of 65 are infected with this disease. The group we treat mostly is an active working, young patient group between the ages of 30-40. Because the shoe wearing variations of patients in this group show differences, we often see this disease at this age, as there are patients who are very mobile and do a lot of sports.
5- Does choosing the wrong shoes cause Hallux Valgus?
Choosing the wrong shoes alone is not a factor that leads to Hallux Valgus. There must be a genetic infrastructure in our patient, that is, there must be a familial predisposition. If such patients wear narrow, high-heeled pointed-toe shoes (stilettos), it is inevitable that the disease will progress and the symptoms will become more serious.
6- How about Hallux Valgus surgery?
The surgical technique varies according to the degree and type of the disease. Already, in order for the treatment to be successful and permanent, it is necessary to first determine which type of Hallux Valgus the patient has to what degree and to choose the appropriate treatment accordingly. The treatment of the disease is not completely possible without surgery. Without surgery, only preventive measures are taken to reduce the patient’s complaints. But the complete treatment is the complete correction of the deformity in the bone, shaping the bone from a new one so that it does not repeat.
7- Can both feet be operated on in the same session in Hallux Valgus surgery?
Both feet can be operated on in the same session. But when Hallux Valgus is at a more advanced level in one foot and at an earlier stage in the other foot, we usually prefer to operate on the advanced foot first. Then, if the other leg progresses, we do it. In this way, it passes easier after surgery, and patients may not complain too much about the other after advanced surgery. If both legs are advanced, they are done at the same time.
In some cases, when the disease reaches very advanced stages over the years, we need to operate on the feet one by one, as we need to intervene with another special technique.
8- What is the recovery time of Hallux Valgus surgery in Istanbul?
Our patients can walk without support by standing up a few hours after the operation on the day they have the operation, giving them a full load. In this way, we will shorten the healing process of the disease.
This process usually proceeds in this way. On the first day, they can get up normally, step on it and walk. On the third day, they become able to do every job in daily life. 1 to 2. They can also return to their normal work life during the week. Unless, of course, this is a job that will be worked standing up all the time. One important point is that there is no need to use any cast, crutches after this operation. Patients do not need bed rest. We give appropriate rest time according to the work they are working on. The only thing we want is that they should wear the shoes that will be given for 6 weeks after the operation. It is no different from normal shoes, but it has a design that will provide postoperative comfort of patients and protect the surgical site. With this shoe, they can quickly return to their normal daily lives in their movements. We have had many patients who participated in weddings, invitations and celebrations with Hallux Valgus postoperative shoes by closing the shoes with long dresses.
9- What are the techniques used in Hallux Valgus surgery?
More than one technique can be applied in Hallux Valgus surgery. The surgical technique is determined according to which type of Hallux Valgus the patient has and the degree of the disease. It is the technique that we perform by making a minimal incision of 3.5 cm from only one place that we apply in Hallux Valgus, which is the most common over-advanced thumb protrusion and has not exceeded a certain degree in angular terms. In more advanced types of the disease, different techniques are applied as the angular difference progresses. There is also a technique made by making an incision from both the lower and upper part of the foot. In this technique, the patient’s postoperative recovery process may be longer than in the other technique. But if this is not done with this technique, there may be a possibility of recurrence of the same disease in the future. For this reason, it is necessary to design the right treatment according to the situation on the foot.
10- Does Hallux Valgus disease become difficult to treat as it progresses?
In fact, it is a condition that applies to all diseases. As it progresses too much in Hallux Valgus, that is, as the deformity increases, let’s not say its treatment is more difficult, but it becomes more complicated. It can be fully treated again. Patients can regain their health completely and permanently, but to indicate some differences; the duration of surgery may be extended, and the recovery time of the patient after surgery may be extended.
Op. Dr.
Adult and Pediatric Orthopedist, Florya WM MedicalPark Hospital Istanbul
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Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.
Physician's Resume:
Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.
Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.
In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.
Awards:
Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.
Certificates:
Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .
Professional Members:
American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.
Disclaimer:
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