Description
The HV combines several strains that are:
hallux abductus if M1P1 > 10 °;
a metatarsus varus if M1M2 > 10 °;
a metatarsus elevatus
pronation of the big toe (not always present).
These deformations are not necessarily at the same time. There is an obstruction, which can be very painful to the medial edge of the first metatarsal head.
Etiology [edit]
This malformation is a female-dominated and often bilaterale1. There are two main forms: one is acquired by progressive failure of the first metatarsal (aging, repetitive strain injuries, overload) systems. It is hallux valgus secondary, which represents 70% of the cases. In this case, the role of a bad fit is important (too narrow shoes) 2.
The other, related to a lack of orientation of the metatarsal head, is called "juvenile" as it appears in the second decade of the life of the patient. It is hereditary and transmitted by the mother with genetic penetrance variable of 72%. It represents 30% of the cases.
In humans, it is often associated with overweight and the presence of plats3 feet.
Pathophysiology or deformity [edit] mechanisms
Lateral subluxation of the proximal phalanx on the metatarsal head [edit]
Consequences of this lateral subluxation of the proximal phalanx on the metatarsal heads, are observed several secondary changes
Retraction of the capsule on its side ("fibular") side
Thinning of the capsule on its medial ("tibial") side
Medial surface of varying sizes
Pronation of the hallux to in relation to the intensity of the deviation
Medial deviation of the first metatarsal with the intermetatarsal angle value. This was the stripping of the sesamoid, anchored laterally by the transverse ligament of intermetatarsal deep.
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