Orthoses and other conservative methods in hallux valgus

Introduction and objective: Hallux valgus is a common deformity (about 23%) in adult population. Deformation of the fist ray and pain causes gait pattern changes and lower life satisfaction. There are many suggestions how to treat bunion. The method of first choice is conservative treatment. One of the most popular option are orthoses of different kinds and functions. The aim of this article is to review the conservative methods of treatment and orthotic management of bunionsand its effectiveness. Materials and methods: PubMed and Google Scholar databases were searched. The criteria for qualifying the articles for the review were the following keywords: bunion, hallux valgus, orthoses, foot deformity. 21 articles from 2018 to 2023 were analyzed. Description of the state of knowledge: Conservative treatment includes orthoses, shoe modification, analgesics, and exercises. But the most popular are the first two methods. There are many types of orthoses used for hallux valgus, i.e. dynamic and static orthoses, separators, insoles and splints. Orthoses are used to reduce hallux valgus angle (HVA) and pain, and inhibit the progression of deformity in a long term. Studies show that dynamic orthoses have a greater effect on reducing HVA and pain compared to static orthoses. In addition, they are more frequently and willingly chosen by patients. Also, toe separators have a significant impact on minimizing pain and improving toe alignment. Summary: Significant reduction of pain and HVA are observed in both short-term and long-term effects when using dynamic orthoses and toe separators. Dynamic orthoses are also more likely to be chosen by patients for their convenience. However, all types of orthoses are beneficial to patients' well-being. A change of footwear also helps to stop the progression of the deformity and prevents recurrence after surgery.