무지 외반증의 진단 및 병태생리

Abstract

Hallux valgus is a lateral deviation of the first phalanx and medial deviation of the first metatarsal at the first metatarsophalangeal (MP)joint. Its incidence has increased due to developing footwear. The etiologies include fashion footwear, genetic causes, anatomical abnormalityaround the foot, rheumatoid arthritis, and neuromuscular disorders. Physiologic alignment of the first MP joint is maintainedby congruent and symmetric alignment of the articular surface of the first proximal phalanx and first metatarsal head, physiologic relationshipof the distal first metatarsal articular surface and the first metatarsal shaft axis, and stable balance of soft tissue around the firstMP joint and stable tarsometatarsal joint. Several factors have been associated with hallux valgus, including pes planus, hypermobilityof the first tarsometatarsal joint, flattened shape of the first metatarsal head, increased distal metatarsal articular angle, and deformationof the medial capsular integrity. History and physical examination are very important to diagnosis of hallux valgus. Simple radiographyprovides information on deformity, particularly in weight-bearing anteroposterior and lateral radiographs. Understanding the etiologiesand pathophysiology is very important for success in treatment of patients with hallux valgus.