Hallux Valgus With Overriding

A 69-year-old female patient with type 2 diabetes diagnosed at the age of 55 years and treated with antidiabetic tablets was referred to the outpatient diabetic foot clinic because of a recurrent ulcer over her first left metatarsal head. The patient had no macroangiopathic complications; peripheral neuropathy was found on examination.

Hallux valgus with fixed varus deformity and clawing of second toe in supraductus was noticed, together with callus formation

Figure 3.14 Hallux valgus with overriding toe

under her first metatarsal head and ulceration of its medial aspect (Figure 3.14).

Hallux valgus and the associated varus posture of the first metatarsal bone cause various deformities of the other toes, such as varus, clawing and valgus formation. The long and short extensor tendons of all the toes shrink like bowstrings, causing subluxation of the phalangeal bases. Contractures of tendons and joint capsules result in fixation of the deformity. Due to the deformity of the third and fourth toes the heads of the three central metatarsal bones become lowered, resulting in their exposure and callus formation. In more severe cases of hallux valgus, the line of load is displaced progressively towards the medial side of the foot, and the longitudinal arch becomes lower, leading to pes planovalgus.

Keywords: Overriding toe; hallux valgus

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