Skip to Main Content

++

Condition/Disorder Synonyms

++

  • Hallux valgus
  • Bunion

++

ICD-9-CM Code

++

  • 735.0 Hallux valgus (acquired)

++

ICD-10-CM Code

++

  • M20.10 Hallux valgus (acquired), unspecified foot

++

Preferred Practice Pattern

++
++

Key Features

++

Description

++

  • Valgus deviation (lateral, abduction) of the great toe (hallux) and varus deviation of the 1st metatarsal
  • Some rotation (valgus rotation) at the 1st metatarsal also possible
  • Static subluxation of 1st metatarsophalangeal joint (MTP)
  • Tissue surrounding 1st metatarsal joint may be inflamed and tender
  • “Bump” on medial side of the 1st toe partly due to
    • Inflammation of the bursal sac
    • Osseous (bony) anomaly on the mesophalangeal joint (where first metatarsal bone and hallux meet)
    • Large part of the bump tends to be the head of the 1st metatarsal, as it deviates medially in relation to the phalange

++

Essentials of Diagnosis

++

  • Diagnosis usually made by clinical examination or x-ray
  • Can be an independent diagnosis, not associated with disease process

++

General Considerations

++

  • Important to correct forefoot weight distribution following surgical correction or another bunion will develop
  • Need to address barefoot walking or improper footwear

++

Demographics

++

  • Most common in women: male-female ratio 9:12
  • 22 to 36% if cases are in adolescents2
  • Hereditary component
  • Poor footwear: improper fit, pointed toe, narrow forefoot
  • Dancers at higher risk

++

Clinical Findings

++

Signs and Symptoms

++

  • Irritated skin around bunion
  • Pain in 1st metatarsal with walking
  • Paresthesia in 1st metatarsal
  • Global ligamentous laxity
  • Joint redness and pain
  • Shift of big toe towards others
  • Depression of 2nd metatarsal with possible formation of hammer toe
  • Callus and blister formation around bunion
  • Difficulty finding shoes with proper fit
  • Lateral subluxation of the flexor hallucis longus (FHL) muscle2

++

Functional Implications

++

  • Pain with standing
  • Pain in affected toe with ambulation
  • Inability to wear stiff shoes
  • Need to wear larger shoes to accommodate bunion
  • Altered gait pattern and mechanical issues of the forefoot

++

Possible Contributing Causes

++

  • Pes planus (flat feet)
  • Excessive pronation
  • Genu valgus
  • Limited dorsiflexion (tight heel cord)
  • Abnormal bone structure
  • Arthritis
  • Leg length discrepancy
  • Congenital Grebe syndrome
  • Neurologic conditions, including

++

Differential Diagnosis

++

++

Means of Confirmation or Diagnosis

++

Imaging

++
++

Findings and Interpretation

++

  • Increased angle between first and second metatarsals

++

Treatment

...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

Create a Free MyAccess Profile

* Required Fields

Note: If you have registered for a MyAccess profile on any of the Access sites, you can use the same MyAccess login credentials across all sites.

Passwords must be between 6 and 40 characters long (no whitespace), cannot contain characters #, &, and must contain:
  • at least one lowercase letter
  • at least one uppercase letter
  • at least one digit

Benefits of a MyAccess Profile:

  • Remote access to the site off-campus on any device
  • Notification of new content via custom alerts
  • Bookmark your favorite content such as chapters, figures, tables, videos, cases and more
  • Save and download images to PowerPoint
  • Self-Assessment quizzes saved for quick review
  • Custom Curriculum access for both instructors and learners

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.