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Friday, February 7, 2020

Hallux Varus: Splinting Possibility


Dear Dr. Blake,

I came across an article from Podiatry today regarding non surgical solutions for patients who had a failed hallux valgus surgery in the past, this is my situation - I am a 55 year old woman - that is active and busy at work.  I live in NYC, otherwise I would make an appointment to see you. I am suffering from this condition  after my bunions surgery went wrong. I am really looking for some kind of orthotics to help me with basic things as walking - since my big toe is always going to the outside - is there something else than taping it together that you can recommend?

Please I really appreciate your help and will be really thankful with any ideas/tips about it.

Thank you!

Dr. Blake's comment: For walking, get 1/4 inch adhesive felt from Alimed and place it along the medial side of the big toe to gently push towards the 2nd toe. 
https://www.alimed.com/felt-plain-and-adhesive.html?pid=71891

A local brace shop should be able to use multiform, also from Alimed, to fashion a sleeping brace. Depending on how tight your tissues are, they can slowly move the first and 2nd toes closer. A sheet is cut out about 8 inches long and 4 inches wide. My little video here shows the way they would wrap the multiform. A sock will have to be worn with it.

 https://www.icloud.com/attachment/?u=https%3A%2F%2Fcvws.icloud-content.com%2FB%2FAX3GxRhBCmvKSgCBRR1T7W_rsp1qAdqnLIxCG0JiCYJLgVKAGB0_xTEZ%2F%24%7Bf%7D%3Fo%3DAhMws-pMZr_EyWlMldfUmGpiP1tCSq5lpm9mpzGPoMEH%26v%3D1%26x%3D3%26a%3DCAogy7KaaxWHJf4HlITvLmVne3lDGqP0jWe3O2P_bPFWfM4SJxD1s4CSgi4Y9cP75YsuIgEAKggByAD_fxxETlIE67KdaloEP8UxGQ%26e%3D1583714591%26k%3D%24%7Buk%7D%26fl%3D%26r%3D5FED7B9F-275F-4FC7-8E44-E3EA89D039D5-1%26ckc%3Dcom.apple.largeattachment%26ckz%3D92E7AC4E-8C1A-4612-9089-7BA3BF80F571%26p%3D43%26s%3DHzXROJt9T5Ze2NxP_lS6Fs1CR5Y&uk=IlC2Hp8yayJaQE0LrcdshQ&f=IMG_6599.MOV&sz=68183935

https://www.alimed.com/alimed-multiform.html?refSrc=921124&nosto=productpage-nosto-1

You also need to strengthen the right muscles. So, metatarsal doming must be done with the toes taped together along with single leg balancing. Hope this helps. Rich
PS you can always go to PT and have them make sure you are do the right exercises, but also increase the mobility of the lateral and medial capsules of the joint to allow it to be pulled back. 

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.