Clinical Assessment

Radiological Assessment

Radiological views - 4

NORMAL grade HV angle?
INTER-METATARSAL ANGLE?

MILD
HALLUX VALGUS ANGLE
INTER-METATARSAL ANGLE

MODERATE
HALLUX VALGUS ANGLE
INTER-METATARSAL ANGLE

SEVERE
HALLUX VALGUS ANGLE
INTER-METATARSAL ANGLE

Normal Distal Articular Set Angle and Proximal Articular Set Angle?

Congruent Hallux Valgus - 4 factors

Interphalangeal Hallux Valgus

• Often associated with ?

• May be the main deformity in ?

• Treated by?

Tarso-Metatarsal Joint Instability
Usually associated with?
• Noted on clinical exam but what can confirm this?

Treatment Options - NON-OPERATIVE (4)

HV Surgery Considerations (4)

Soft Tissue Release (McBride’s) description

Exostectomy (Silver’s procedure)

Excision Arthroplasty (Keller’s)

Complications - 5

Excision Arthroplasty (Mayo’s)

Complications (3)

Osteotomy

Ideal Osteotomy

The Modified Mau-Reverdin Double Osteotomy

Mitchell Osteotomy

Mitchell Osteotomy - 2 disadvantages

Chevron osteotomy

Complications with Chevron and other distal osteotomies

Scarf Osteotomy

Troughing

Feathering

BASAL OSTEOTOMY

LAPIDUS PROCEDURE/First tarsometatarsal joint arthrodesis

ARTHRODESIS indications? 3

Akin osteotomy

Common Practice in Glasgow
• Mild deformities?

Moderate deformity

• Severe deformity - 2

• First MTPJ arthritis:

First ray hypermobility / First TMTJ arthritis: