Dr. Milan Handl
Specialist Orthopedic Surgeon
Hallux valgus belongs to typical orthopedic diagnoses. It is known as the lateral deviation of the big toe along with medial angulation of the first metatarsal bone. The cause is unknown, although causes have been described mainly tight footwear, pronation of the hind foot, flat foot, generalized joint laxity etc. Genetics or family history can also be a factor to be considered. The Hallux Valgus Angle (HVA) is formed by the longitudinal axis of the first metatarsal and the proximal phalanx of the big toe.
The Intermetatarsal Angle (IMA) is formed by the longitudinal axis of the first two metatarsals. An HVA less than or equal to 15 degrees and an IMA less than or equal to 9 degrees are considered normal. Clinically it is characterized by pain, little tolerance to walking and chronic history of valgus deviation of the first toe as well as supination, forming therefore the bunion – serous bursa in the head of the first metatarsal bone. Conservative treatment is attempted when it is first diagnosed. It consists of the utilization of custom-made insoles, braces, orthopedic shoes etc. The surgical treatment is performed when there are difficulties not improved with orthopedic treatment.
There are many surgical techniques for the treatment of hallux valgus which makes us suspect that there is still no ideal technique that could be used in all cases. Many of these techniques have obtained satisfactory results, although the key to avoiding recurrences is correcting the metatarsus primus varus.