Hallux Valgus and Hypermobility

        The articular hypermobility in the 1st TMT is often associated with a general ligamentary hyperlaxity (more than 4º in the sagittal plane and more than 8º in the horizontal plane).

         Very frequently, Hallux Valgus in those cases will both be acute and appear early in life. Since the condition will recur often in spite of regular treatment, the best surgical procedure is the metatarso-cuneiform arthrodesis of lapidus, especially when the Hallux Valgus returns after the 1st metatarsal osteotomy.

        Myerson gives the following advice : Add a screw which will point towards the base of the 2nd metatarsal or the second wedge.