Hallux conditions

• Hallux conditions - Valgus:

  • Lateral deviation at hallux, medial deviation of 1st metatarsal
  • develops over time
  • big toes metatarsal gets pushed medially, so phalanges moves laterally to try and compensate
  • causes rubbing at metatarsalphalangeal joint
  • surgical options such as joint reconstruction - scarf osteotomy - remove a chunk of metatarsal out and realign toe

  
• Hallux conditions - Rigidus:

  • Limited movement at 1st metatarsalphalangeal joint (extension)
  • Osteoarthritic change at 1st metatarsalphalangeal joint -> leads to thinning of the cartilage, decrease joint space and formation of osteophytes -> limits movement of big toe especially extension
  • treatment: fixation of the joint which ends in fusion proximal phalanx and metatarsal -> results in less mobility but removes pain

  
• Management of Hallux Valgus and Hallux Rigidus:

  • Passive joint mobilisations if pain/stiffness
  • Joint ROM exercises
  • Muscle strengthening
  • Proprioception/balance rehabilitation
  • Orthotics – if over pronated
  • Advice on appropriate wide fitting footwear
  • Surgery – cheilectomy/osteotomy/fusion