title: The pathogenesis of hallux valgus.
abstract: The first ray is an inherently unstable axial array that relies on a fine balance between its static (capsule, ligaments, and plantar fascia) and dynamic stabilizers (peroneus longus and small muscles of the foot) to maintain its alignment. In some feet, there is a genetic predisposition for a nonlinear osseous alignment or a laxity of the static stabilizers that disrupts this muscle balance. Poor footwear plays an important role in accelerating the process, but occupation and excessive walking and weight-bearing are unlikely to be notable factors. Many inherent or acquired biomechanical abnormalities are identified in feet with hallux valgus. However, these associations are incomplete and nonlinear. In any patient, a number of factors have come together to cause the hallux valgus. Once this complex pathogenesis is unraveled, a more scientific approach to hallux valgus management will be possible, thereby enabling treatment (conservative or surgical) to be tailored to the individual.
authors.affiliation: University Hospital of Wales, Cardiff, CF14 4XB, UK. footandanklesurgery@gmail.com
authors.forename: A M
authors.initials: AM
authors.lastname: Perera
authors.forename: Lyndon
authors.initials: L
authors.lastname: Mason
authors.forename: M M
authors.initials: MM
authors.lastname: Stephens
mesh_terms: D000367:Age Factors; D000368:Aged; D015984:Causality; D005260:Female; D005531:Foot Deformities, Acquired / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D006215:Hallux Valgus / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D010027:Osteotomy / Q000379:methods* / Q000534:rehabilitation; D010147:Pain Measurement; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome