J Korean Foot Ankle Soc.  2014 Jun;18(2):43-47. 10.14193/jkfas.2014.18.2.43.

Diagnosis and Pathophysiology of Hallux Valgus

• Jang KS
• Kim TW
• Kim HJ

• KMID: 2181659
• DOI: http://doi.org/10.14193/jkfas.2014.18.2.43

Abstract

Hallux valgus is a lateral deviation of the first phalanx and medial deviation of the first metatarsal at the first metatarsophalangeal (MP) joint. Its incidence has increased due to developing footwear. The etiologies include fashion footwear, genetic causes, anatomical abnormality around the foot, rheumatoid arthritis, and neuromuscular disorders. Physiologic alignment of the first MP joint is maintained by congruent and symmetric alignment of the articular surface of the first proximal phalanx and first metatarsal head, physiologic relationship of the distal first metatarsal articular surface and the first metatarsal shaft axis, and stable balance of soft tissue around the first MP joint and stable tarsometatarsal joint. Several factors have been associated with hallux valgus, including pes planus, hypermobility of the first tarsometatarsal joint, flattened shape of the first metatarsal head, increased distal metatarsal articular angle, and deformation of the medial capsular integrity. History and physical examination are very important to diagnosis of hallux valgus. Simple radiography provides information on deformity, particularly in weight-bearing anteroposterior and lateral radiographs. Understanding the etiologies and pathophysiology is very important for success in treatment of patients with hallux valgus.

Keyword

Hallux valgus; Diagnosis; Pathophysiology

MeSH Terms

Arthritis, Rheumatoid
Axis, Cervical Vertebra
Congenital Abnormalities
Diagnosis*
Flatfoot
Foot
Hallux Valgus*
Head
Humans
Incidence
Joints
Metatarsal Bones
Physical Examination
Radiography
Weight-Bearing

Figure

• 

  Figure 1. The structure of tendon, ligament and joint capsule around first metatarsophalangeal (MP) joint. (A) Schematic illustration of plantar surface of first MP joint. (B) Schematic illustration of lateral capsule of first MP joint.

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  Figure 2. Parameters which should be measured in hallux valgus. HVA: hallux valgus ankle, IMA: intermetatarsal angle, DMAA: distal metatarsal articular angle, PPAA: proximal phalangeal articular angle, MTCA: metatarsocuneiform angle.

Reference

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