Hallux valgus, commonly known as a bunion, is a complex deformity of the first ray of the forefoot. It is characterized by a lateral deviation of the hallux (big toe) and its consequent distancing from the median axis of the body. This deformity can be red and painful, and it can disrupt daily activities. Hallux valgus deformity is typically diagnosable through a physical exam, and imaging is important as it can evaluate whether there is damage to the first metatarsophalangeal (MTP) joint.
The condition has a familial tendency that depends on autosomal dominant inheritances transmission with incomplete penetrance. Other etiologic factors include gender (more common in women than men), footwear (tight, pointed), and arthritic or metabolic conditions such as inflammatory arthropathies, connective tissue disorders, and neuromuscular diseases.
Treatment for hallux valgus ranges from conservative to surgical management. There are over 150 different surgical procedures described for correction of these forefoot problems. However, no method is available thus far that sufficiently corrects all hallux valgus deformities. Pre and post-operative hallux valgus management principles include physical therapy, orthotics, and pain management.
