Hallux valgus (Ballenzeh)

Hallux valgus - commonly known as Ballenzeh malposition of the big toe - is one of the most common foot diseases in the western world, which often develops in childhood by wearing too tight or small footwear. How does a hallux valgus develop and which symptoms does it show?

What is a hallux valgus?

Hallux valgus is the medical term for a common malposition of the big toe, in which the toe of the toe joint - which is the joint that connects the toe with the foot - is pushed outward in the direction of the inner edge of the foot. This creates on the inside of the foot above the joint as Gelenkausstülpung a bursa - this increasing bump is popularly referred to with the expression Ballenzeh or bump. The big toe pushes out with its bony base in the joint to the outside and thereby makes a slight turn.

How does a hallux valgus develop?

In addition to plant-inheritable connective tissue weakness, the most common cause of hallux valgus is the wearing of false footwear, which restricts the foot in the forefoot area, leading to a more triangular foot shape in the toe area and pushing the toe-off foot bones apart. If the shoe has a heel, the weight of the foot shifts to the forefoot, breaking the normal arch of the forefoot and creating a splayfoot.

Tight footwear with heels is worn by women rather than men in our western society, with the result that only 10 percent of all diseases occur in men - even the weaker female connective tissue carries a certain amount of blame. In countries where women walk barefoot or wear foot-friendly sandals, hallux valgus is virtually non-existent. The wearing of too tight or too small stockings promotes the development of a splayfoot and a hallux valgus, as the normal foot posture is so permanently suppressed.

The chronic misalignment of the toe and toe bone leads to the fact that important muscle tendons of the toe muscles are displaced from their anatomically correct place, the big toe can no longer be used on the other toes and the development of splayfoot and hallux valgus accelerates.

How does a hallux valgus manifest?

The hallux valgus can cause no problems except the aesthetically unsightly bump - but the malposition of the great toe in the joint often leads to progressive cartilage wear and then pain during movement. In addition, as the disease progresses, there is an increasing problem of space in the shoe: In the area of ​​big toe bale, the available space becomes ever narrower, the shoe presses and rubs against the bale so that bursitis can develop.

Inflammation, swelling and cartilage damage then cause pain with every strain on the foot: walking, running and even simple toe movements in the air are uncomfortable. Incidentally, the size and malpositioning of the hallux valgus do not give any indication of the severity of the symptoms - even a pronounced bale is sometimes symptom-free.

How to recognize a hallux valgus?

The protrusion and bulging of the big toe ball is visible to the naked eye. Often a corneal callus forms over the mechanically stressed bale, an inflammation of the bursa reacts painfully to pressure.

In addition to the degree of deformity of the toe bones (in relation to the metatarsal bones), the radiograph also indicates the condition of the joint: to what extent is the cartilage damaged in the toe joint and how strongly have bony margins formed? Depending on the findings, the treating physician will select the treatment method that is the most promising for the present symptoms and radiological findings.

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