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Why can’t I wear heels?

What is a stiff big toe?

Stiff big toe (Hallux rigidus) is a disorder of the big toe joint. It causes pain and stiffness in the joint and over time the patient becomes more and more difficult to bend his finger, thus acquiring difficulty in walking and sports activities.

Many patients confuse hallux rigidus with the knuckle (Hallux Valgus), which affects the same joint, but is a very different condition, with different treatment. Because hallux rigidus is a progressive condition, joint movement and foot function gradually decrease over time.

What are the symptoms of this condition?

The first symptoms include pain and stiffness in the big toe during use (walking, standing, etc.), difficulty in certain activities (running, climbing stairs) and swelling, redness and heat (points of inflammation) around the joint. As the condition becomes more severe, other symptoms may develop, such as difficulty wearing shoes (such as heels for women) because there is severe pain on contact of the inflamed joint with the shoe or the development of osteophytes that deform the joint.

How is it diagnosed?

The sooner this condition is diagnosed, the more effective the treatment. Therefore, the best time to visit a specialist is when you notice the first symptoms. In the diagnosis of hallux rigidus, the first step is the clinical examination, which will reveal the stiffness of the big toe, any deformities, osteophytes and disorders of the joint pocket. The diagnosis is always made by a specialized orthopedist after a good and detailed clinical examination. The doctor will then refer the patient for an X-ray. X-rays are needed to determine the stage of rigidus.

How is it treated and when do we choose the surgery?

In many cases, early treatment can prevent or delay the need for surgery in the future. Conservative treatment for mild to moderate cases of hallux rigidus may include the creation of special orthotics, physiotherapy and intra-articular injections of corticosteroids.

When conservative treatment does not bring the desired result and the patient continues to be significantly limited in his daily life, the treatment is performed surgically. Various types of surgery are available to treat hallux rigidus. The method of surgery depends on the extent of the deformity, the size of the osteophytes, the age of the patient and his functional needs (level of activity of the patient). The operation is performed without a skin incision, with a transdermal technique.

Do you need hospitalization for this operation?

This is a minimally invasive procedure lasting about 30 minutes. The patient is discharged the same day and does not need to stay in the hospital for treatment. The anesthesia is always local (block), ie the patient does not need to receive general or dorsal anesthesia.

The complication rate of this operation is less than 1%, when it is performed by specially trained orthopedic surgeons in percutaneous foot surgery.