Hallux Valgus
Progressive lateral deviation of the great toe with medial eminence prominence, often accompanied by pain and functional footwear difficulty.
Overview
Hallux valgus is a complex three-dimensional deformity involving lateral deviation of the hallux, medial deviation of the first metatarsal, pronation of the hallux, and subluxation of the first MTPJ. It reflects failure of the medial soft-tissue restraints under biomechanical load.
Epidemiology
Prevalence varies widely but may exceed 20 percent of adults and 35 percent of those over 65, with a strong female predominance. Family history, hypermobility, pes planus, and restrictive footwear contribute.
Symptoms
Patients report pain at the medial eminence exacerbated by shoes, transfer metatarsalgia, and functional discomfort. Examination evaluates the passive correctability, hallux MTPJ range, first tarsometatarsal mobility, and associated lesser toe deformities.
Imaging
Weight-bearing AP, lateral, and sesamoid views allow measurement of hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), and sesamoid position. Lateral view assesses first ray elevation and arthrosis.