Toe misalignment

Hallux valgus

Hallux valgus is the syndrome in which a big toe (hallux) shows a distinct, abnormal position (valgus). This is related to the collapse of the hindfoot (e.g. due to misalignment of the foot, excessive inward rotation or flat feet), the length of the first toe, the type of shoe worn and predisposition.

Hallux rigidus

Hallux rigidus is a stiffening (rigidus) of a big toe (hallux) due to osteoarthritis (wear and tear) in the joint where the big toe meets the metatarsal (MTP1 joint). The big toe can appear slightly crooked, though less so than with a classic hallux valgus. Extra bone growth (an osteophyte or 'parrot beak') often forms on top of the MTP1 joint, so you may see a thickening on the big toe.

Hammer toe or claw toe

Beyond the big toe, other toes can display misalignments. These are commonly called hammer or claw toes.

A clear diagnosis requires radiography with the patient in standing position. Hallux valgus is irreversible. Its evolution can be slowed through the use of insoles, (small changes in) your choice of shoe and possibly with exercises.

Surgical intervention involves disconnecting the joint on one side, reducing the angle between the first two metatarsals, tightening the joint on the other side and, sometimes, also straightening and shortening the first toe. This realigns the big toe into a straight position and removes the swelling or lump on the side of the joint.

Latest publication date: 14/05/2024