[Modern methods of surgical treatment of hallux valgus deformity]. / Wspólczesne metody leczenia operacyjnego deformacji koslawej palucha.

ABSTRACT

Hallux valgus is the most common deformity of the foot, affecting 2-4% of the population. The disease is mostly genetic, but there are also exogenous factors. Conservative treatment for the use of orthotics is usually ineffective and only surgery leads to a complete cure. The indications for surgery are pain and/or problems with shoe choosing. AP and lateral foot standing X-ray film is necessary for the proper qualifications. Depending on the size of the hallux valgus angle (HVA) and intermetatarsal angle (IMA) deformations are divided into mild, moderate, advanced and severe. In addition, we assess congruency of the first metatarsophalangeal joint (MTP I). Depending on the degree of deformation and the ascertained pathology we combine different procedures, such as bunionectomy with medial capsulorrhaphy, osteotomy of basal phalanx of the great toe, distal, midshaft or proximal osteotomy of the first metatarsal, double osteotomy of the first metatarsal, MTP I joint arthrodesis and arthrodesis of medial cuneiform-first metatarsal I joint. In non-congruent MTP I joint we usually perform lateral release. In some indications we also use arthroplasty and minimally invasive techniques. Only the proper qualification for surgery provides a good clinical effect.