Toe misalignment

Hallux valgus

Hallux valgus is the syndrome where the big toe (the hallux) is clearly misaligned (i.e. 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 the big toe due to arthrosis (wear and tear) in the joint where the big toe is joined to the metatarsal (MTP1 joint). The big toe can appear slightly crooked, though less so than with a classic hallux valgus. Often, additional bone growth is seen on top of the MTP1 joint (osteophyte or ‘parrot beak’), showing as a swelling 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 inlays, (small changes in) type of shoes worn and potentially through 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: 29/08/2023
Supervising author: Dr. Desmyter Stefan