HALLUX VALGUS

(Radiograph of the foot with Hallux valgus)
(note that the big toe is deviating to the lesser toes. The 2 small bones (sesamoids) underneath the big toe are not longer in their normal position. The joint of the big toe (1st metatarsal phalengeal joint) is not congruent)

This is a condition where the big toe deviates towards the lesser toes and rotates outwards. This condition is commonly associated with a prominence over the base of the toe called a “bunion”. This deformity can be accentuated by inflammation due to rubbing of shoewear. The general incidence of Hallux valgus in the population is 2 – 4 per cent. This is the same for population wearing shoes and barefooted. However, the incidence increases to 48 per cent with those wearing small pointed high healed shoes. The incidence of Hallux valgus is higher among women. It can also occur in childhood where the condition is hereditary and transmissible by the mother with variable genetic penetrance of 72 per cent. The usual form has an undeniable family tendency.



FORMS

COMMON FORMS

There is frequently a combination of these factors: a certain family tendency and the deformation which gradually increases during the years to shoewear.

• Youthful forms (which thus occur during childhood)

The genetic factor is paramount. These are often severe with the deforming forces of shoewear.

• Arthritic forms

The degradation of the capsule and the ligaments leads to malalignment. This results in inflammation of the joint involved with Hallux valgus.

RARER FORMS

• Post-traumatic

Hallux valgus can occur after an accident which has rupture or divided the articular capsule. It can also occur in post traumatic disorders leading to flat feet. The overuse of the extensor halucis tendons will lead to hallux valgus.

• Neurological

Hallux valgus can appear because of the paralysis of certain muscles, or the spasticity of other muscles generating a muscular imbalance.