This produces what is known as a “hammer toe.”
A corn is also prone to develop on the top of the toe from pressure of the shoe.
In the early stages of hallux valgus, where the bunion is present but not painful, relief may be obtained by wearing comfortable, wide-toed shoes, and sometimes by inserting a rubber wedge between the first and second toe to help preserve the normal alignment.
Operations should not be performed for purely cosmetic reasons as most people are not happy with the result.
But when the pain is severe the results of operation are excellent, and most accept the slight deformity which results and it still looks much better than the ugly deformity of the hallux valgus, bunion, hammer toe complex.
In operation the bunion or bursa is removed and any overgrowth of the bone or joint is shaved off.
The base of the first bone of the big toe is removed so that the toe is shortened and a false joint made.
This normally results in loss of control of movement of the toe, but no loss of stability.
If there is a hammer toe deformity as well, this is usually corrected by “filleting” or removing one of the small bones of the toe, or by shortening one bone and shaving its end to make it a spike and driving it into the head of the other phalanx, thus rendering the whole toe shorter and straighter, and the joint is removed.
These procedures usually involve less than a week in hospital but it may take two or three months for the person to walk comfortably, although return to work is usually possible in three weeks.
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