Objective: To determine the prevalence of hallux valgus and its relationship to wearing high-heel shoes in Chinese females. In the January's issue of Orthopedics magazine there is a paper which
presents the results of more widely used method of correction of hallux valgus - the so- called Scarf osteotomy. Be alert to hallux valgus deformity symptoms. Hallux valgus is de benaming voor een
standsafwijking van de grote teen. A bunion is a very common forefoot problem.
A deviation of the disal portion of the great toe, at the metatarsophalangeal joint, toward the outer or lateral side of the foot. A deviation of the tip of the great toe, or main axis of the toe,
toward the outer or lateral side of the foot. There are over 100 named surgical techniques for the correction of hallux abductovalgus, most of which are modifications of a number of principles of
approach. The big toe tilts outwards, crowding the smaller toes, and a bony lump (called a bunion) appears on the inside of the foot. These are used to remove the bunion and to divide one or more of
the bones of the front of the foot. Compared with standard (open) surgery, this procedure uses smaller cuts to the foot and X-rays or endoscopy to see inside the foot. Scar symptoms are a recognized
complication of forefoot surgery. The tourniquet was released, and the skin was sutured.
Greenberg (1979) measured the following radiographic angles: calcaneal inclination angle, talar declination angle, lateral talo-calcaneal angle, dorsoplantar talo-calcaneal angle, cuboid abduction
angle and talo-cuboid angle. In order for foot orthoses to reverse hallux valgus they have to create a net adduction moment on the hallux at the 1st MTPJ; a net abduction moment of the 1st met at
Lisfrancs joint and de-rotate the met and hallux- end of story. If memory serves, one of the best pathomechanical theories I read on hallux valgus was by Snijders et al.- biomechanics of hallux
valgus and spread foot.
Associated deformities may include second digit hammertoes and flexible or rigid flat foot. Instability of the second digit may allow a more rapid progression of hallux valgus, as it is unable to act
as an adequate lateral buttress. If surgery it to be contemplated it is imperative that peripheral blood flow be adequate for healing. Understand that bunions are progressive and that non-surgical
treatments alleviate symptoms but do not limit progression. The most important indication for surgery is pain, not deformity, although there will often be concern about the appearance of the deformed
joint. It is usually a combination of bone and soft tissue surgery.
Contributing factors, if present, include gastrocnemius or gastrocsoleus equinus, flexible or rigid pes plano valgus, rigid or flexible forefoot varus, dorsiflexed first ray, hypermobility, or short
first metatarsal. During normal propulsion, Ball Of Foot Pain
approximately 65Â° of
dorsiflexion is necessary at the first metatarsophalangeal joint, yet only 20-30Â° is available from hallux dorsiflexion. Note the greater deformity of the right foot (image left) versus the left
foot (image right).