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Rare Halluces Valgi
A. Post-traumatic Causes of Hallux Valgus
- Traumas which split the
metatarso-phalangeal internal capsule and ligament or trauma-induced rupture
with impact, causing an extreme and acute lateral deviation of the big toe.
- Fracture of several metatarsal
necks, bringing about a lateral deviation of the toes, and, in time, the
appearance of Hallux Valgus.
- Iatrogenic
(treatment-induced) : Amputation of
the 2nd toe (if the big toe is not resting on the 3rd), causing a
worsening or the onset of Hallux Valgus.
- Traumas (split or fracture) of the
anterior tibial tendon: In order to
compensate for the problem, patients will favour the use of the big toe’s long
extensor (EHL). Herewith is a sample of
a complete rupture of the anterior tibial tendon. The EHL works too much to compensate for the
dorsi-flexion of the ankle. After a
while, an acute and painful Hallux Valgus
came about with lateral displacement of the EHL and soon after, another
displacement of the sesamoid belt.
Of course, treatment must take into
account the specific cause of the trauma as well as correct the Hallux Valgus which developed in the
weeks or months following the trauma.
B. Neurological Hallux Valgus
Isolated paralysis-paresis of the
anterior tibial muscle (rare cases); loss of dorsi-flexion of the ankle.
Herewith : A anterior tibial muscle paresis generated an
acute and painful Hallux Valgus.
Treatment needed to bring about a tendon transfer for the ankle
dorsi-flexion together with the conventional remedy for the secondary Hallux Valgus.
Cerebral paralysis; Central nervous system
trauma; Cardio-vascular episode; subarachnoid haemorrhage, Spina Bifida and others.
In these cases as well, the treatment
will vary according to the initial cause of the problem. Tendon transfers or mid-tarsal arthrodeses
are often necessary to correct the architectural misshaping of the foot.
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