Hallux Valgus

Hallux valgus is common, more frequent in women, and tends to run in families. In the cases where symptoms are severe, the first metatarsal head deviates medially and the phalanges laterally, causing a painful condition that often affects daily life because it makes shoe wearing difficult. To prevent the condition, it is recommended to avoid shoes with narrow toe boxes and high heels, and wear arch-support insoles that follow the shape of the longitudinal arch of the foot. Nonsurgical treatment, such as strengthening of intrinsic muscles, may improve less severe symptoms. For mild cases, distal osteotomy of the first metatarsal is performed, and for moderate cases, proximal metatarsal or metatarsal shaft osteotomy is preferred. For severe cases with instability of the first tarsometatarsal joint, the Lapidus method is recommended. Postoperatively a bulky bandage is used, while external fixation with a cast is not necessary. The patient may walk on the heel from the day after surgery and to resume active weight-bearing after 8 weeks, followed by a gradual return to sports.