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Hallux Valgus

  1. It is outward/lateral deviation of great toe
  2. It is the commonest of the foot deformities (and probably of all musculoskeletal deformities)
  3. Splaying of fore foot, with varus angulation of 1st metatarsal, predispose lateral angulation of great toe in people who wear shoes
  4. Metatarsus primus varus may be congenital or result from loss of muscle tone in fore foot in elderly. It is also common in rheumatoid arthritis. Family history is obtained in 60%.
  1. Elements of deformity are
    1. Lateral deviation and rotation of hallux, together with prominence of medial side of head of 1st metatarsal (bunion).
    2. Prominence of 1st metatarsal head is due to subluxation of metatarsophalangeal joint; there may be an overlying bursa & thickened soft tissue. The capsule of the joint is stretched medially but contracted laterally. When exposed at operation, medial prominence looks like an exostosis, but there is no true exostosis.
    3. Lateral deviation of hallux causes overcrowding of lateral toes and sometimes overriding.
    4. When valgus exceeds 30 or 40°, the great toe rotates into pronation so that nail faces medially and sesamoid bones of flexor hallucis brevis are displaced laterally.
    5. In long standing cases metatarsophalangeal joint becomes osteoarthritic and osteophytes may develop.
    6. Surgical treatment gives relief of pain.

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Hallux Valugs Angle & Intermetatarsal Angle


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  1. Surgical deformity Correction
  2. Hallux Valgus brace
  3. Hallux Valgus spacer


Treatment of Hallux Valgus

  1. Hallux Valgus <15 Degrees - Conservative
  2. Hallux Valgus <25 Degrees: a. Chevron osteotomy b. Mitchell osteotomy
  3. Hallux Valgus 25-40 Degrees: a. Chevron osteotomy with Akin procedure
  4. Hallux Valgus with arthritis changes arthrodesis

Athletic Pubalgia/ Sportman’s Hernia/ Gilmore’s Groin/ Groin Disruption


Athletic pubalgia refers to chronic pain in the inguinal or pubic region in athletes that is noted primarily on exertion mainly due to adductor longus muscle strain.



  1. Primary management is conservative (Rest, Ice, Ant inflammatory medications etc)
  2. Surgery (Multiple techniques) is indicated if conservative therapy fails. Nesovic’s operation (bilateral) is reserved for resistant cases

Haglund’s Deformity

Retrocalcaneal bursitis with characteristic deformity

Description: Haglunds-Syndrome

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