Manejo de las complicaciones del hallux valgus

Abstract

The first metatarsal is often deviated in varus from the axis of the second metatarsal, rotated on its longitudinal axis and often shorter than the second. The first x-ray may show a valgus deviation at the level of the interphalangeal joint, a deformity known as interphalangeal hallux valgus.Varus deviation is observed in the cuneo-metatarsal joint and a valgus deviation is observed in the distal joint facet of the metarsophalangeal.There are changes in the soft tissues surrounding the MT-F joint. The medial capsule is attenuated and the lateral contracted. Tendons flexors and extensors are laterally aligned by the valgus of the phalanx. When the tendons contract, the deformity increases.The abductor muscle of the hallux is placed plantarly, and the adductor with its two insertions in the lateral sesamoid moves to the first intermetatarsal space, altering its articulate relation with the metatarsal head.All these described deformities vary in intensity, and increase if the patient presents with joint hypermobility or severe pronation of the foot.