Hallux valgus and hypermobility of the first ray: facts and fiction

Abstract

The aetiology of hallux valgus with regard to stability of the first metatarsocuneiform joint has historically been subject to much debate. Associations between the magnitude of the intermetatarsal angle and the hallux valgus angle have previously been established. Metatarsocuneiform joint coronal plane mobility is necessary for a concomitant increase in both of these angles. Although metatarsocuneiform joint hypermobility has been implicated in the development of a hallux valgus deformity, isolated sagittal plane instability has thus far not been proven to be a definitive cause.

Comparison of dorsal and dorsomedial displacement in evaluation of first ray hypermobility in feet with and without hallux valgus

“…A recent review has suggested that isolated sagittal plane hypermobility not be the cause but rather the result of a hallux valgus deformity [38]. Others authors have also shown that a hallux valgus deformity causes further exacerbation of a pre-existing hypermobility of the first ray [28].…”

A Retrospective Study of 63 Hallux Valgus Corrections Using the Osteodesis Procedure

“…With deteriorating protection by the medial metatarsosesamoid ligament, the first metatarsal will progressively increase its varus deviation. Furthermore, the first metatarsal would, in association with the MPV deformity, become hypermobile in the sagittal plane (24,25). However, the mobility and reducibility of the displaced first metatarsal in the coronal plane for MPV correction without an osteotomy has been questioned by many surgeons owing to concerns for possible obstruction by the displaced Fig.…”

Evaluation of the Pain and Foot Functions in Women with Hallux valgus deformities

“…This result may be related with the changes in the preference of footwear due to the pain and position of hallux in HV deformity. Furthermore, the presence of HV deformity in populations that do not wear shoes also suggests different underlying factors [8]. Other factors that are considered to cause HV, such as the family history, presence of bunions and flatfoot, and footwear use habits have also been investigated in our study.…”

“…Over-pronation or prolonged pronation of the back of foot, acquired pes planus, contracture of the Achilles tendon, increased joint laxity, hypermobility of the metatarso-cuneiform joint, familial factors, increase in body weight, gender, and certain neuromuscular disorders such as cerebral palsy and stroke are among the primary intrinsic factors of HV [8,9]. It has been noted that long-lasting activities performed while standing also increase the severity of deformity [1,6,8,10]. Wearing shoes with high heels and narrow toe boxes are extrinsic factors that expedite the formation of deformity and increase its severity.…”