Hallux valgus

Hallux valgus is a common foot deformity characterized by a lateral deviation of the hallux and a corresponding medial deviation of the first metatarsal, leading to a bony protrusion at the base of the toe.

The pathophysiology of hallux valgus is multifactorial, with genetic factors playing a significant role. Biomechanical factors, including the collapse of the arch and the vertical orientation of the first metatarsal axis, also contribute to the development of the deformity. Additionally, wearing shoes that are too short or have high heels can contribute to the condition.

The prevalence of hallux valgus is estimated at 23% in adults aged 18-65 years and 35.7% in elderly aged > 65 years.

Risk factors for hallux valgus progression include age, female gender, and family history. Wearing tight, narrow shoes, or high heels can contribute to the development of hallux valgus. Additionally, certain occupations requiring prolonged standing or walking and forefoot disorders, such as metatarsalgia and lesser toe deformities, can also influence the development of hallux valgus.

Clinically, hallux valgus presents with pain, swelling, and a visible deformity at the base of the big toe. The condition can also cause difficulty in wearing certain types of footwear, including high-heeled and narrow shoes. Hallux valgus is a chronic, progressive, and degenerative condition. Over time, the angle of deformity increases, and symptoms may worsen. In the late stages, the hallux may become painful and lose its functional utility, leading to impaired gait.

The prognosis of hallux valgus varies. Without intervention, symptoms may worsen and complications, such as osteoarthritis of the first metatarsophalangeal joint, may arise. However, surgical intervention can correct the deformity and alleviate symptoms, with high rates of patients returning to both comfortable and heeled shoes post-surgery.