Hallux Valgus Deformity Assessment and Correction Techniques

The hallux valgus deformity, commonly known as a bunion, is characterised by the lateral deviation of the great toe and medial drift of the first metatarsal, often accompanied by pronation of the metatarsal head and subluxation of the sesamoids. Clinical assessment combines physical examination of toe alignment, gait observation for shifts in centre of pressure and patient-reported outcomes on pain and footwear difficulties. Radiographic evaluation employs standardised measurements—including the hallux valgus angle, intermetatarsal angle and distal metatarsal articular angle—to grade severity and guide treatment planning. Advanced imaging modalities, such as weight-bearing CT and three-dimensional analysis, have revealed multiplanar hypermobility at the first metatarsocuneiform joint, emphasising the need for derotational correction in complex cases. Non-operative measures encompass custom orthoses, splints and targeted exercise programmes to alleviate symptoms and delay progression in mild deformities. Surgical correction ranges from established open osteotomies—such as chevron, Scarf and Lapidus arthrodesis—to percutaneous and minimally invasive approaches that aim to reduce soft-tissue trauma. Integration of intraoperative guidance systems and digital inclinometers has further enhanced osteotomy precision. Comparative evidence indicates that minimally invasive methods can match open techniques in angular correction while offering reduced postoperative pain and faster recovery. Given the high prevalence of hallux valgus, particularly among older women, robust assessment and evolving correction strategies remain critical to improving functional outcomes and quality of life.

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Hallux Valgus Deformity Assessment and Correction Techniques publication trend

The graph below shows the total number of articles in hallux valgus deformity assessment and correction techniques across all publications each year (not limited to Nature Index journals).

Technical terms

Hallux valgus angle (HVA): The angle formed between the axes of the first metatarsal and the proximal phalanx of the great toe, used to quantify lateral deviation.

Intermetatarsal angle (IMA): The angle between the first and second metatarsal bones, indicative of medial separation and severity of deformity.

Distal metatarsal articular angle (DMAA): The orientation of the articular surface of the first metatarsal head relative to its shaft, reflecting joint congruence.

Osteotomy: A surgical procedure in which bone is cut and realigned to correct deformity.

Minimally invasive surgery (MIS): Techniques utilising small incisions and percutaneous instruments to minimise soft-tissue disruption and accelerate recovery.

Sesamoid bones: Small ossicles beneath the first metatarsophalangeal joint that can become displaced in hallux valgus and influence surgical planning.

References

1. Improving the Accuracy of Metatarsal Osteotomies in Minimally Invasive Foot Surgery Using a Digital Inclinometer: Preliminary Study. Sensors (2024).
2. Minimally invasive versus open chevron osteotomy for hallux valgus correction: a randomized controlled trial. International Orthopaedics (2018).
3. Mobility of the first metatarsal-cuneiform joint in patients with and without hallux valgus: in vivo three-dimensional analysis using computerized tomography scan. Journal of Orthopaedic Surgery and Research (2015).
4. Metatarsal Pronation in Hallux Valgus Deformity: A Review. JAAOS Global Research and Reviews (2020).
5. Minimally Invasive vs. Open Surgery for Hallux Valgus: A Meta-Analysis. Frontiers in Surgery (2022).