A Family Doctor's Tale - HALLUX VALGUS

DOC I HAVE HALLUX VALGUS

HALLUX VALGUS also known as BUNION deformity is the deformity of the big toe metatarsopharyngeal(MTP) joint in whivh there is medial protrusion and lateral deviation of the great toe.

Shoewear does not cause hallux valgus.

HALLUX VALGUS occur as a result of :
1.heredity

2.flat foot (pes planus)

3.metatarsal primus varus

4.hypermobile first metarsal cuneiform joints

5.abnormal length of first metatarsal

6.joint laxity

Symptoms:
The onset is usually gradual with a wide spectrum of manifestations from simple deviation to severe deviation and deformity.

1.Normal intermetatarsal angle (the angle between the first and second metatarsals is 9 degrees or less.

2.the normal first MTP joint angle is less than 15 degrees.
Any increase of 15 degrees angle is considered as lateral deviation of the first metatarsopharygeal joint.

3.The big toe is turned inwards towards the second causing a medial protrusion of the MTP joint called a bunion.

4.in severe cases the first toe can overlap the second toe or the second toe may cover the inturned big toe.

5.there is pain on walking

6.there is difficulty in wearing shoes

Treatment:
Conservative:
1.In mild cases no treatment is required

2.Shoe wear modifications to increase the width of the toe box will relieve pressure of the MTP joint and help in walking.

3.Pads and splints may also help to relieve symptoms.

Surgery:
The main purpose is to restore the normal anatomical relation of the big toe MTP joint.
1.Osteotomy to realign the first metatarsal

2.Fusion of MTP joint

Prognosis:
90 per cent of patients will have good results after surgery

Conservative treatment can relieve the pain on walking but the deviation may still become worse.