A hallux valgus is fixed abduction of the first metatarsophalangeal joint of the great toe. It is usually due to metatarsus primus varus which is medial deviation or adduction of the first metatarsal with an increased first - second metatarsal angle.
A normal first metatarsophalangeal angle is <15° on an AP weight-bearing foot radiograph 2; anything greater indicates hallux valgus. The first - second intermetatarsal angle should be <9° on a weight-bearing foot radiograph 2.
There is a close association between the degree of metatarsus primus varus and hallux valgus. The combined deformities are present to some degree in most patients. Hallux valgus may be a result of metatarsus primus varus, and surgical correction is often based on this theory.
Treatment and prognosis
As a surgical intervention, the scarf osteotomy is a widely used method 4-5.
- 1. Vanore JV, Christensen JC, Kravitz SR et-al. Diagnosis and treatment of first metatarsophalangeal joint disorders. Section 6: Other disorders. J Foot Ankle Surg. 42 (3): 152-4. doi:10.1053/jfas.2003.50041 - Pubmed citation
- 2. Karasick D, Wapner KL. Hallux valgus deformity: preoperative radiologic assessment. AJR Am J Roentgenol. 1990;155 (1): 119-23. AJR Am J Roentgenol (citation) - Pubmed citation
- 3. George HL, Casaletto J, Unnikrishnan PN et-al. Outcome of the scarf osteotomy in adolescent hallux valgus. J Child Orthop. 2009;3 (3): 185-90. doi:10.1007/s11832-009-0177-6 - Free text at pubmed - Pubmed citation
- 4. Berg RP, Olsthoorn PG, Pöll RG. Scarf osteotomy in hallux valgus: a review of 72 cases. Acta Orthop Belg. 2007;73 (2): 219-23. Pubmed citation
- 5. Crevoisier X, Mouhsine E, Ortolano V et-al. The scarf osteotomy for the treatment of hallux valgus deformity: a review of 84 cases. Foot Ankle Int. 2002;22 (12): 970-6. Pubmed citation