Most of the time, they involve the front part of the foot and the toes, with the most common and well-known ones being the bunion of the big toe (the bunion), the bunion of the fifth toe, the drop of the metatarsals, the deformities of the little toes, such as clubfoot, gampsodactyly, hammertoedactyly, as well as flat feet, clubfoot and many more. The specific deformities may be accompanied by pain and difficulty in walking.

How do deformities occur and what are the usual symptoms?

The causes are not entirely clear, with 40% of the appearing deformities remaining unexplained. More generally, the deformities can be present from birth or be acquired, as for example the so-called acquired vlasioplatipodia which is created by a deficiency of the posterior tibial tendon, which degenerates and lengthens while the rupture of this tendon creates the same deformity. For bunions, heredity and footwear are very often blamed, with the “tight shoe” factor playing an important role.
Symptoms depend on the type of deformity, but most often patients experience pain and often notice changes in their gait.

Diagnosis

Most deformities can be identified by examining the foot by a specialist doctor, who checks the patient’s clinical picture and may request imaging tests to confirm the diagnosis, assess the extent of the problem, and plan treatment.

Which deformities need surgical treatment?

“Depending on the type and extent of the condition, the orthopedist will suggest the most appropriate treatment plan. It always depends on the severity of the symptoms and how much they affect the patients’ quality of life. There are cases of patients who are bothered by even minor deformities and others who face a more extensive problem and report no significant discomfort.
In most cases, if the deformities do not cause difficulty in walking, pain or a problem with footwear, then we try to treat them conservatively. But when the pain is daily, there is difficulty and conservative means do not provide the solution, then we perform corrective surgeries that also provide the final result”, points out the Mr. Ioannis Vailas Director Orthopedic Surgeon at Metropolitan HospitalDoctor of the University of Athens, ex-Chairman of the Foot and Ankle Department, of the Hellenic Society of Orthopedic Surgery and Traumatology and adds:
“For example, in the cases of hammertoedactyly, gampsodactyly and kurtodactyly, some conservative treatment is initially recommended with special silicone splints, which fix the fingers in their normal anatomical position. However, if the conservative treatment does not bring the desired results, then the doctor can recommend the surgical treatment of the deformities with the aim of definitive treatment and symptom relief. The same in cases of bunions of the big toe, in case the placement of silicone spacers between the first and second toe does not bring the desired result.”

New techniques and in which cases they are applied

“The new percutaneous techniques combine the evolution of technology with the evolution of microsurgical instruments, which have allowed us to have a very good result. These are surgeries that are performed through holes, that is, with small holes of a few millimeters, such as the laparoscopic method of general surgery. The doctor, through these holes, performs the operation by watching the entire procedure from the screen which is connected to a fluoroscopic machine, which accurately transmits the image and allows the surgeon to intervene successfully.
For example, in the most common operation performed on the shank, the alignment of the bone is usually held with two titanium screws, which are biocompatible, do not cause a problem in the body, and do not need to be removed. The most important thing is that they eliminate recurrence, which most patients who face this problem fear,” emphasizes the expert.

The advantages of this technique

“The advantages are that the operations are performed with local anesthesia, the pain is minimal compared to open surgery, i.e. the pain can be treated with common painkillers for 2-3 days, walking is immediate with a special postoperative shoe, and no requires a hospital stay. In most cases, stitches are not even needed in the hole created during the surgery.
It is worth noting that it is very important if someone is facing any of the above issues, to contact a doctor who specializes in the foot,” concludes Mr. Vailas.