Hallux valgus

<table border="1" cellpadding="5"><tbody><tr><th colspan="2">Diagnostic</th></tr><tr><td style="background-color: #bef2d3; text-align: center;" colspan="2"><strong>Clinique</strong></td></tr><tr><td colspan="2"><p><strong>Le diagnostic est clinique&nbsp;(<a href="https://www.ordotype.fr/liens-utiles/photo-et-radio-hallux-valgus" target="_blank" rel="noopener">images</a>) :</strong></p><ul><li data-w-id="8952987b-a5a4-8a2c-fdfe-ecefec9f5e16" data-wf-id="[&quot;8952987b-a5a4-8a2c-fdfe-ecefec9f5e16&quot;]" data-automation-id="dyn-item-diagnostics-input">Douleur lors de la marche :<ul><li data-w-id="d28dbb4b-3160-8f2f-d349-7722481caf73" data-wf-id="[&quot;d28dbb4b-3160-8f2f-d349-7722481caf73&quot;]" data-automation-id="dyn-item-diagnostics-input">Bord interne du pied initialement, puis</li><li data-w-id="22c600f9-e7f1-3a2e-4714-eddf8d2e8a30" data-wf-id="[&quot;22c600f9-e7f1-3a2e-4714-eddf8d2e8a30&quot;]" data-automation-id="dyn-item-diagnostics-input">Vo&ucirc;te plantaire,&nbsp;</li><li data-w-id="ce41c96c-2227-e043-30d9-dc960e116200" data-wf-id="[&quot;ce41c96c-2227-e043-30d9-dc960e116200&quot;]" data-automation-id="dyn-item-diagnostics-input">+/- 2^&egrave;me orteil</li></ul></li><li data-w-id="1ef469a2-b5bd-6724-1ce3-9c1d51b890ec" data-wf-id="[&quot;1ef469a2-b5bd-6724-1ce3-9c1d51b890ec&quot;]" data-automation-id="dyn-item-diagnostics-input">Examen physique debout (la charge aggrave la d&eacute;formation), puis assis et couch&eacute; :<ul><li data-w-id="c52b6faa-0eef-f8f6-e641-33241ed5a440" data-wf-id="[&quot;c52b6faa-0eef-f8f6-e641-33241ed5a440&quot;]" data-automation-id="dyn-item-diagnostics-input">D&eacute;viation de l'axe du gros orteil,</li><li data-w-id="d485b80a-afc3-d210-183c-e8b5c5ca6d10" data-wf-id="[&quot;d485b80a-afc3-d210-183c-e8b5c5ca6d10&quot;]" data-automation-id="dyn-item-diagnostics-input">Pr&eacute;sence d'une bosse sur le bord interne du pied en regard de la m&eacute;tatarso-phalangienne du premier rayon,</li><li data-w-id="46825090-26d9-3e9b-4bba-8703e729fb40" data-wf-id="[&quot;46825090-26d9-3e9b-4bba-8703e729fb40&quot;]" data-automation-id="dyn-item-diagnostics-input">D&eacute;formation des autres orteils en griffes &agrave; un stade avanc&eacute;,</li><li data-w-id="41daffc6-c321-a1b7-ae39-b7051f720c5c" data-wf-id="[&quot;41daffc6-c321-a1b7-ae39-b7051f720c5c&quot;]" data-automation-id="dyn-item-diagnostics-input">+/- Durillons et cals des orteils (voir <a href="https://www.ordotype.fr/pathologies/durillon-cor" target="_blank" rel="noopener">fiche</a>).</li></ul></li></ul></td></tr><tr><td style="background-color: #bef2d3; text-align: center;" colspan="2"><strong>Radiographies</strong></td></tr><tr><td style="text-align: center;"><strong>Indication</strong></td><td><ul><li>Douleurs persistantes,</li><li>Bilan avant chirurgie.</li></ul></td></tr><tr><td style="text-align: center;"><strong>Clich&eacute;s</strong></td><td><ul><li>Pieds (<a href="https://www.ordotype.fr/ordonnances-types/radio-hallux-valgus" target="_blank" rel="noopener">ordonnance</a>) : bilat&eacute;rales, debout, face et profil</li><li>+/- Cheville (<a href="https://www.ordotype.fr/ordonnances-types/radio-de-cheville-hallux-valgus" target="_blank" rel="noopener">ordonnance</a>, pr&eacute;ciser le c&ocirc;t&eacute; sur l'ordonnance)</li></ul></td></tr><tr><th colspan="2">Traitement</th></tr><tr><td style="background-color: #bef2d3; text-align: center;" colspan="2"><strong>Traitement conservateur (1^&egrave;re intention)</strong></td></tr><tr><td><p style="text-align: center;"><strong>Adaptation du chaussage</strong></p></td><td><ul><li data-w-id="b72302d4-31e3-f9fa-ea2d-110eb57dab1d" data-wf-id="[&quot;b72302d4-31e3-f9fa-ea2d-110eb57dab1d&quot;]" data-automation-id="dyn-item-diagnostics-input">Chaussures larges et souples,</li><li data-w-id="a23747b1-18fe-abf7-d3bb-31e4e3c143d8" data-wf-id="[&quot;a23747b1-18fe-abf7-d3bb-31e4e3c143d8&quot;]" data-automation-id="dyn-item-diagnostics-input">&Eacute;viter ou limiter au maximum le port de chaussures &agrave; bouts pointus ou de talons hauts</li></ul></td></tr><tr><td style="text-align: center;"><strong>+/- Orth&egrave;ses</strong><br /><strong>(<a href="https://www.ordotype.fr/ordonnances-types/podologie-hallux-valgus" target="_blank" rel="noopener">ordonnance</a>)</strong></td><td>Faible niveau de preuve</td></tr><tr><td style="text-align: center;"><strong>Traitement symptomatique<br />(<a href="https://www.ordotype.fr/ordonnances-types/hallux-valgus-traitement-conservateur" target="_blank" rel="noopener">ordonnance</a>)</strong></td><td><ul><li data-w-id="7b8d37c2-cfa0-64d1-72f8-e0624431c512" data-wf-id="[&quot;7b8d37c2-cfa0-64d1-72f8-e0624431c512&quot;]" data-automation-id="dyn-item-diagnostics-input">Antalgiques,</li><li data-w-id="4eb7be93-d900-3696-36c3-5b4ce640b7aa" data-wf-id="[&quot;4eb7be93-d900-3696-36c3-5b4ce640b7aa&quot;]" data-automation-id="dyn-item-diagnostics-input">Traitement des durillons et cals (voir <a href="https://www.ordotype.fr/pathologies/durillon-cor" target="_blank" rel="noopener">fiche</a>)</li></ul></td></tr><tr><td style="background-color: #bef2d3; text-align: center;" colspan="2"><strong>Indications chirurgicales</strong></td></tr><tr><td style="text-align: left;" colspan="2"><p>Apr&egrave;s &eacute;chec du traitement conservateur :</p><ul><li data-w-id="a9a53afc-ac9f-ab40-3956-3a5e06998b84" data-wf-id="[&quot;a9a53afc-ac9f-ab40-3956-3a5e06998b84&quot;]" data-automation-id="dyn-item-diagnostics-input">Douleurs persistantes,</li><li data-w-id="1a243bb8-654c-5983-3a79-0a30e478f54b" data-wf-id="[&quot;1a243bb8-654c-5983-3a79-0a30e478f54b&quot;]" data-automation-id="dyn-item-diagnostics-input">Douleurs &eacute;tendues &agrave; la base du 2^&egrave;me orteil t&eacute;moignant d'une instabilit&eacute; du pied.</li></ul><p>Les anomalies radiographiques ne constituent pas &agrave; elles seules une indication chirurgicale.</p></td></tr></tbody></table>‍