Definition
Lateral deviation of the great toe with medial deviation of the first metatarsal, producing a bunion deformity.
Clinical features
- Medial eminence pain
- Forefoot shoe-wear problems
- Overlapping toes and transfer metatarsalgia
- Cosmetic concern
Assessment
- Hallux valgus angle
- Intermetatarsal angle
- First TMT instability if present
- MTP joint congruity
- Associated lesser toe deformity
Treatment
Non-operative
- Shoe modification
- Pads or spacers
- Analgesia
Operative
- Distal osteotomy for mild deformity
- Shaft or proximal osteotomy for more severe deformity
- Lapidus procedure when first TMT instability is important
- MTP fusion in severe arthritis or salvage situations
Diagram
