Hallux Valgus evolved
Third stage: Claw toes and front round foot.
«2nd ray syndrome».
The reason for consultation is no longer the exostosis but more often a pain or a horn at the top of the second toe which is in claw, usually with a painful callus under the base of the second toe (metatarsalgia). This «2nd ray syndrome» is the direct consequence of hallux valgus and it is necessary to treat hallux valgus at the same time as this claw toes to avoid recurrence.
Treatment of claw toes.
If they are beginning and then reducible, they will disappear with the treatment of their cause (hallux valgus). It is rarely necessary to lengthen the tendons, or to perform righting arthroplasty.
If they are old and important, it will then be necessary to associate with the correction of hallux valgus a surgery not only on the toes and frequently on the metatarsals.
Treatment of metatarsalgia
(pain under the metatarsal heads with plantar and forefoot callus)
According to your case:
– In some cases, metatarsals heads are raised by so-called “per cutaneous” surgery.
– But if the metatarsalgia are important or if the joints are dislocated, then it will be necessary to do the intervention of Helal or Weil which is an axial relaxation operation (by decreasing the length of the metatarsal ) removing the claws from the toes and the “front round foot”. In some cases this osteotomy can be performed by «percutaneous surgery», which simplifies the operation.
Fourth stage of the hallux valgus or «complex Foot»
The untreated evolution is then made towards:
– the aggravation of the deformation of the second toe, with dislocation.
– the extension of static disorders to the entire forefoot with claws from the other toes and a large, painful callus under the sole of the foot (anterior round forefoot with middle pain).
Thanks to current techniques, the most deformed forefeet are accessible for surgical treatment. In the vast majority of cases, all joints can be conserved.