The pathogenesis of hallux valgus.

@article{Perera2011ThePO,
  title={The pathogenesis of hallux valgus.},
  author={A M Perera and Lyndon W. Mason and Michael M. Stephens},
  journal={The Journal of bone and joint surgery. American volume},
  year={2011},
  volume={93 17},
  pages={
          1650-61
        }
}
The first ray is an inherently unstable axial array that relies on a fine balance between its static (capsule, ligaments, and plantar fascia) and dynamic stabilizers (peroneus longus and small muscles of the foot) to maintain its alignment. In some feet, there is a genetic predisposition for a nonlinear osseous alignment or a laxity of the static stabilizers that disrupts this muscle balance. Poor footwear plays an important role in accelerating the process, but occupation and excessive walking… 

Figures and Tables from this paper

Hallux Valgus
TLDR
More than 100 different procedures have been described to treat hallux valgus; they include combinations of soft tissue balancing, metatarsal osteotomies, and fusion of either the metatarsophalangeal (MTP) or tarsometatarsal (TMT) joint.
Review of current hallux valgus management options
TLDR
Surgical management of hallux valgus is dominated by first metatarsal osteotomies performed through open surgery or minimally invasive techniques, and Hallux Valgus angle has been found to be the single most important parameter for surgical outcome prognostic.
Between-side Comparisons of Iliotibial Band Flexibility and the Tibial Torsion Angle in Subjects with an Asymmetric Hallux Valgus Angle
TLDR
A literature search for causes of HV did not produce any data on the general population, and no study has yet compared lower leg alignment and muscle flexibility between two sides in subjects with asymmetric HV angles (HVAs).
Short Term Behaviour of Fixed-Loop Cortical Suspension System Used for Surgical Treatment of Hallux valgus
TLDR
The results show good stability of the reduction and good reliability of the suspension system, with a six months follow-up, and the need for biomechanical testing in controlled laboratory studies.
Treatment of Progressive First Metatarsophalangeal Hallux Valgus Deformity: A Biomechanically Based Muscle-Strengthening Approach.
  • W. Glasoe
  • Medicine
    The Journal of orthopaedic and sports physical therapy
  • 2016
TLDR
This clinical commentary provides instruction in a strengthening approach for treatment of hallux valgus deformity, by addressing the moment actions of 5 muscles identified as having the ability to counter the halluxvalgus process.
The treatment of hallux valgus.
TLDR
The clinical outcome of present treatments seems to be good in most cases, but large-scale randomized trials are still needed to verify the efficacy of the wide variety of operations and fixation techniques that are currently being offered.
Biomechanical Cadaveric Evaluation of the Role of Medial Column Instability in Hallux Valgus Deformity
TLDR
A novel cadaveric foot model where a possible influence of medial column instability in first metatarsal pronation is suggested, and the naviculocuneiform joint was the most important one responsible for pronation of the medial column.
Hallux valgus deformity: Treatment options, post-operative management, and return to sport
TLDR
This narrative review is to give an insight about the treatment options, related post-operative rehabilitation, and return to sport for hallux valgus, an increasingly common injury in the athletic population.
Outcome of Hallux Valgus Deformity Correction Using Mitchell Osteotomy with Screw fixation
TLDR
Evaluating the efficiency of Mitchell corrective osteotomy using screw fixation in correction of hallux valgus deformity in two groups with moderate-severe deformities with halluxValgus angle below 30 degrees and moderate- severe deformity with an angle above 35 degrees concluded that this procedure could be a simple and effective procedure to correct halluxvalgus deformation with high levels of patient satisfaction.
Prevention and treatment of hallux valgus
TLDR
When deciding on an adequate surgical option for hallux valgus surgery, the patient’s subjective symptoms, the expectations of the patient, the degree of the de-formity, and the radiographic measurements are considered in order to correct the deformity and prevent complications after surgery.
...
...

References

SHOWING 1-10 OF 232 REFERENCES
[Pathogenesis of hallux valgus].
TLDR
In the presence of a pes planovalgus, lowering of the navicular and talus bones results in a deformation of the hindfoot, and all the tendons that cross the first metatarsophalangeal joint now function as adductors, and promote the further development of hallux valgus.
Hallux valgus due to cuneiform-metatarsal instability.
TLDR
A biomechanical rationale for the treatment of severe hallux valgus deformity by realignment and arthrodesis of the first cuneiform metatarsal (CM) joint is presented and a modern variant of the Lapidus procedure is presented.
Medial Deviation of the First Metatarsal Head as a Result of Flexion Forces in Hallux Valgus
TLDR
The bio-mechanical model of Snijders et al., 31 which states that contraction of flexor muscles of the hallux worsens its valgus angle and causes medial deviation of the first metatarsal head is validated on patients to validate the model on patients.
Functional hallux limitus: a review.
TLDR
The aim of this article is to review the functional hallux limitus literature and its reported effects on gait, and some of the key and inherent problems with obtaining accurate data for joint motion measurement in the foot.
Clinical, Quantitative Assessment of First Tarsometatarsal Mobility in the Sagittal Plane and Its Relation to Hallux Valgus Deformity*
TLDR
A pathological mechanism of symptomatic hallux valgus is proposed that relates this pathology with primary weightbearing disturbances in the forefoot where angulation of the first metatarsophalangeal joint is one of the consequences.
METATARSUS PRIMUS VARUS OR HALLUX VALGUS
TLDR
The writer presents the thesis that any operative procedure that does not include the correction of the deformity at its proximal focus is unscientific and inadequate; and that simple cuneiform osteotomy at the metatarso-cuneiform joint, with the redressement of certain secondary changes, is adequate and permanent.
THE NATURAL HISTORY OF HALLUX VALGUS IN ADOLESCENCE AND EARLY ADULT LIFE
TLDR
It is suggested that hallux valgus should be regarded primarily and fundamentally as a subluxation, or tendency to subluxations, of the first metatarso-phalangeal joint.
The Significance of Pes Planus in Juvenile Hallux Valgus
TLDR
The arch index, or ratio of the area of the middle third of the foot to the total footprint area, was calculated and found no significant difference between the arch index of 32 11-year-old children with hallux valgus and 11- year-olds with no first metatarsophalangeal joint deformity.
Mobility of the First Tarsometatarsal Joint in Relation to Hallux Valgus Deformity: Anatomical and Biomechanical Aspects
TLDR
This in vitro study was undertaken to investigate the relation between the mobility of the TMT 1 joint in these two planes and the correlation of the mobility with morphological variables and to study the possible stabilizing effect of the tibialis anterior muscle, flexor hallucis longus muscle, and peroneus longus Muscle on the T MT 1 joint.
Hallux Valgus in Men Part II: First Ray Mobility after Bunionectomy and Factors Associated with Hallux Valgus Deformity
TLDR
Hallux valgus in this group of male patients was not associated with limited ankle dorsiflexion or pes planus, and there was no evidence of first ray hypermobility after a DSTP-PMO.
...
...