Aetiology of hallux valgus
The aetiology of hallux valgus (HV) is complex and multi-factorial: (1,2)
- footwear - exacerbating factor; may enhance the progression of the deformity
- HV occurs in unshod communities as well as shoe wearing ones. However evidence from one study in China revealed that HV was 70 times more common among shoe-wearers than unshod members of the community
- familial incidence - this ranges from 65-85%
- appears to be an autosomal dominant trait with incomplete penetrance - this means that successive generations won't always have the deformity
- generalised joint laxity is more common in patients with HV e.g. Marfan's syndrome and Ehlers-Danlos syndrome may cause joint laxity and also have in marked HV
- in the elderly there may be weak intrinsic muscles of the foot which results in a 'splay foot' type deformity and possible HV; this may also occur in rheumatoid disease
- rock climbing (3)
Reference:
- Perera AM, Mason L, Stephens MM; The pathogenesis of hallux valgus. J Bone Joint Surg Am. 2011 Sep 7;93(17)
- Barnish MS, Barnish J; High-heeled shoes and musculoskeletal injuries: a narrative systematic review. BMJ Open. 2016 Jan 13;6(1)
- Schoffl V, Kupper T; Feet injuries in rock climbers. World J Orthop. 2013 Oct 18;4(4):218-228.
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