Presentation on theme: "Is it possible to sex up bunions by calling it hallux valgus? Mr David R Tollafield Consultant Podiatric Surgeon Villars Medical Conference Walsall Manor."— Presentation transcript:
Is it possible to sex up bunions by calling it hallux valgus? Mr David R Tollafield Consultant Podiatric Surgeon Villars Medical Conference Walsall Manor Hospital (Community Health) Spire Healthcare Little Aston, Sutton Coldfield Ramsay Hospital Halesowen
This presentation (objectives):- Avoiding the confusion Looking at x-rays differently Understanding why Tx is required At the heart of bunion surgery – the sesamoid Degeneration & what it means What is good surgery?
Based on definition represented in ‘clinical skills in Treating the Foot’ Elsevier. Tollafield D R, Kilmartin T K, Prior T D 2005 Simple staging by clinical observation mildmoderatesevere
“Should I wait until it hurts?” “GP says it is not bad enough yet?” “...don’t like the look of it!” “Want to stop it getting like my mother’s” “Can’t get shoes on I want” So when do we treat? Hallux valgus is more of a lady’s problem than a man’s problem
Should we leave this condition? SECONDARY Broad forefoot Shoe pressure Metatarsalgia Skin wear Ulcerations Impingement Chilblains infections PRIMARY Pain Deformity Degeneration
End of midstance, heel lift, toe propulsion How much movement? The sesamoid Root et al 1977 Suggest 20 degrees required
The sesamoid, above is affected as a patella against a femoral head! Tracking misalignment