How to correct and treat enlarged ankle bone

The symptoms of enlarged malleolus are actually the same as hallux valgus, and we should also pay attention to alleviating these conditions through some methods. Current treatments include surgical treatment to help correct this deformity and relieve pain.

1. Non-surgical treatment

For early lesions with mild pain, non-surgical treatment can be used, including wearing shoes with a wide front heel no higher than 2.5 cm, massage, moving the big toe toward the inside of the foot, walking barefoot on sand, exercising the foot muscles, applying hot compresses, and resting. Gymnastics can also be used to correct hallux valgus to a certain extent. That is, rubber bands are put on the first toes on both sides to pull them in opposite directions, twice a day, each time for 5 to 10 minutes. Trying to reduce pressure and friction on the bony prominence is also an effective method, such as placing a soft gasket around the bony prominence. If the pain is limited to the bunion or metatarsophalangeal joint, puncture and drainage of the painful area and local injection of steroids can be performed.

2. Surgery

The purpose of surgical treatment is mainly to relieve pain and correct deformities, and it is suitable for patients in the middle and late stages. Some hallux valgus deformities are severe but not painful and do not require surgery.

More than 200 surgical methods have been reported, which can be summarized into five categories:

① Soft tissue surgery: mainly cutting off the insertion point of the adductor pollicis muscle at the proximal phalanx and relocating it to the fibular side of the first metatarsal head, represented by the McBride surgery;

② Osteectomy: remove part of the bone to relax the contracted soft tissue and relieve symptoms. Commonly used procedures include Mayo surgery and Keller surgery;

③ Correction of the first metatarsal varus osteotomy, or simultaneous soft tissue surgery and/or bone resection;

3. Keller arthroplasty:

① Indications: moderate to severe hallux valgus (30°～45°) with osteoarthritis, aged 55 to 70 years, hallux rigidity and elderly patients with less activity. It is one of the most commonly used surgical procedures for the treatment of hallux valgus. The Keller operation consists of three parts: soft tissue release, medial process resection and proximal phalanx resection. This operation can correct the deformity and relieve the pain of the big toe, but the big toe will be thick and weak for several months to a year after the operation, and the range of motion of the big toe-metatarsophalangeal joint will also be small. This should be explained clearly to the patient before the operation.