Pathogenesis (development of disease)
Hallux valgus is caused by a multidimensional malalignment of the big toe in the metatarsophalangeal joint (often as a result of a splay foot). In its course, there is an ever-increasing imbalance of the foot muscles and ligament structures. Thus, the malalignment continues to increase, resulting in valgus deviation (deviation with outward angulation), dorsiflexion (movement in the ankle toward the dorsum of the foot), and pronation (inward rotation) of the toe, accompanied by subluxation to luxation (incomplete to complete dislocation of the joint) in the metatarsophalangeal joint of the big toe.
Etiology (Causes)
Biographic causes
- Genetic burden from parents, grandparents – autosomal dominant inheritance with incomplete penetrance.
- Positive family history is common
- Ethnic origin – African American origin.
Behavioral causes
- Overweight (BMI ≥ 25; obesity).
- Improper footwear such as shoes with a pointed front and high heels promote the development of hallux valgus
Disease-related causes
- Coxarthrosis (osteoarthritis of the hip joint)
- Gonarthrosis (knee osteoarthritis)
- Pes planus (flat foot)
Other causes
- Achilles tendon / calf muscle shortening.
- Ligament laxity (evidence of excessive extensibility).
