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Published on: February 17, 2018
History of surgical treatments for hallux valgus
1Orthopedic and Trauma Surgery Department, University Hospital of Nancy, Centre Chirurgical Emile Gallé, 49 rue Hermite, 54000, Nancy, France. l.galois@chru-nancy.fr.
Insights
Hallux valgus understanding has evolved from footwear issues to diverse surgical corrections. Modern techniques incorporate biomechanical advancements for hallux valgus treatment.
Area of Science:
- Orthopedics and Podiatry
- Surgical Innovation
Background:
- Historically, hallux valgus was attributed to footwear, with treatments focusing on soft tissue or bone removal.
- Early surgical approaches since 1871 varied, with many techniques becoming obsolete over time.
Observation:
- The understanding of hallux valgus has shifted from a simple soft tissue enlargement to complex biomechanical considerations.
- Numerous surgical interventions have been developed, ranging from conservative soft tissue procedures to joint-sacrificing techniques.
Findings:
- Surgical techniques for hallux valgus have progressed significantly due to advancements in biomechanics, materials, and supportive devices.
- Current approaches include joint fusion (arthrodesis), joint replacement (arthroplasties), conservative soft tissue procedures, and first ray osteotomies.
Implications:
- The evolution of hallux valgus surgery reflects a deeper understanding of foot biomechanics and patient-specific needs.
- Continued innovation in materials and surgical techniques promises improved outcomes for hallux valgus correction.
Abstract:
In the nineteenth century, the prevalent understanding of the hallux valgus was that it was purely an enlargement of the soft tissue, first metatarsal head, or both, most commonly caused by ill-fitting footwear. Thus, treatment had varying results, with controversy over whether to remove the overlying bursa alone or in combination with an exostectomy of the medial head. Since 1871, when the surgical technique was first described, many surgical treatments for the correction of hallux valgus have been proposed. A number of these techniques have come into fashion, and others have fallen into oblivion. Progress in biomechanical knowledge, and improvements in materials and supports have allowed new techniques to be developed over the years. We have developed techniques that sacrifice the metatarsophalangeal joint (arthrodesis, arthroplasties), as well as conservative procedures, and one can distinguish those which only involve the soft tissues from those that are linked with a first ray osteotomy.
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