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The Pathogenesis of Hallux Valgus

Perera, A.M., FRCS(Orth)1; Mason, Lyndon, MRCS(Eng)1; Stephens, M.M., FRCSI2

doi: 10.2106/JBJS.H.01630
Current Concepts Review
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The first ray is an inherently unstable axial array that relies on a fine balance between its static (capsule, ligaments, and plantar fascia) and dynamic stabilizers (peroneus longus and small muscles of the foot) to maintain its alignment.

In some feet, there is a genetic predisposition for a nonlinear osseous alignment or a laxity of the static stabilizers that disrupts this muscle balance. Poor footwear plays an important role in accelerating the process, but occupation and excessive walking and weight-bearing are unlikely to be notable factors.

Many inherent or acquired biomechanical abnormalities are identified in feet with hallux valgus. However, these associations are incomplete and nonlinear.

In any patient, a number of factors have come together to cause the hallux valgus. Once this complex pathogenesis is unraveled, a more scientific approach to hallux valgus management will be possible, thereby enabling treatment (conservative or surgical) to be tailored to the individual.

1University Hospital of Wales, Cardiff, CF14 4XB, UK. E-mail address for A.M. Perera: footandanklesurgery@gmail.com

2Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland

Copyright © 2011 by The Journal of Bone and Joint Surgery, Incorporated
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