Hallux valgus

• Hallux valgus:

  • Bunion
  • Big toe latterly deviates away from the midline towards the other toe = first metatarsal head sticks out medially
  • Can lead to inflammation of overlying bursa and soft tissue
  • These changes happen gradually
• Exact cause not known, some predisposing factors:

  • Constricting shoes e.g. high heels
  • Increasing age
  • Female
  • Family history
  • Neuromuscular disorders
  • Pes planus (flat foot)
• Complications:

  • Chronic pain
  • Difficulty finding comfortable footwear
  • Increased pressure on MTP joint - risk of callus formation and OA
  • Increased falls risk
• Management depends on severity:

  • Self care - low heeled wide shoes, bunion pads in shoes, ice relief for pain and inflammation
  • Analgesia - paracetamol and/or NSAIDs
  • Podiatry referral for footwear assessment
  • Referral to local MSK services - core stability training, steroid injections
  • Surgery
• Consider surgery if:

  • Progressive symptoms that are not responding to conservative management
  • Second toe involved
  • Significant impact on daily functioning
  • Several surgical options exist - all aim to realign bones and correct deformity