Hallux Valgus

IIPO
 Objectives
• What is Hallux valgus?
• Etiology
• Prescription criteria
• management
Introduction
▶ Hallux valgus means lateral deviation of great toe.
▶ Commonest of foot deformities.
▶ Not a single disorder; but a complex deformity of the
first ray.
▶ Frequently accompanied by deformity and symptoms
in lesser toes.
▶ Varus deformity of first
metatarsal
▶ Valgus of great toe
▶ Great toe bunion formation

A bunion is a bony bump that forms on the joint at

the base of your big toe.
▶ Sex: Causes of Hallux Valgus
▶ Women > Men
▶ Women : Men = 50: 1
▶ Predisposed by pointed
compressive high heeled shoes
Age:
▶ 14-16 in girls and little later in
boys
▶ Symptomatic hallux valgus is
more common after 40 years of
age, mostly bilateral.
▶ Shoes:

▶ Has been considered as extrinsic cause of

Hallux Valgus: compressive shoe wearing habits.
▶ Tight fitting shoe at toes have been proven as
cause of bunion, corns.
 Clinical features
▶ Symptoms:

▶ Pain in foot
▶ Difficulty in being fitted with
shoes
▶ Gait changes
▶ Corns
▶ Cosmetic deformity
Angle between 1st and 2nd metatarsal. Usually less than 10
degree.
 Classification of hallux valgus

3 types based on Hallux valgus angle

▶ Mild: Angle < 20 degree, intermetatarsal angle usually
less than 11 degree
▶ Moderate: Angle 20 - 40 degree, intermetatarsal angle
between 11 and 18 degree
▶ Severe: Angle > 40 degree, intermetatarsal angle > 16-
18 degree
 Treatment of hallux valgus

▶ Conservative Management:
▶ Young and asymptomatic patients
• Proper fitting shoes with wide
deep toe boxes
• Night splinting
• Great toe separator
 Once the deformity is established, it
is difficult to check the progression
of disease by conservative measures.
 Surgical Treatment

Indications of operative treatment

▶ Failure of non operative measures
▶ Persistent pain that interferes
with daily work
▶ Severe deformity and pain
unlikely to respond to
conservative measures
 Conclusion
▶ Hallux valgus is the most common deformity of foot
▶ Commonly seen an adolescent females and becomes
symptomatic in middle age
▶ Can be treated conservatively if diagnosed early
▶ Surgery is the only option after the deformity
develops.
 Review Questions
• Hallux valgus means medial deviation of great toe. (T/F)
• Hallux valgus is a complex deformity of the first ray. (T/F)
• Males are more prone to hallux valgus deformity. (T/F)
• Normal hallux valgus angle is less than 15 degree. (T/F)
• A wide toe box shoe is recommended for hallux valgus
deformity. (T/F)
 Reference
• Kent K. Wu. Foot Orthoses Principles and clinical application,
Chapter- 1, p 1-14.
Thank you