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foot and ankle problems

This is a condition where the big toe deviates towards the lesser toes and rotates outwards. This condition is commonly associated with a prominence over the base of the toe called a “bunion”. This deformity can be accentuated by inflammation due to rubbing of shoewear.


Pain over the bunion is a common problem.  Patients may also have difficulty in wearing appropriate footwear.

SURGICAL treatment

The surgery for Hallux valgus has had a bad reputation in the pass. There are over 150 different types of surgery for Hallux valgus. Some have had better results than others.

Multiple variables must be taken into account for an effective surgery with less chance of recurrence. This includes:

  • The age of the patient
  • The degree of deviation of the big toe
  • The angle between the 1st and the 2nd metatarsal bone
  • Relative lengths of 1st and 2nd metatarsal
  • The slope of the head of 1st metatarsal (DMAA) and particular anatomy of the head of this metatarsal
  • Osteoarthritis, arthritis.
  • Hypermobility of the 1st ray (very common amongst Asians)
  • Lesser toe deformities

Essentially, the principles of surgery involves correction of soft tissue imbalances causing the deforming forces to deviate the toe and osteotomies to realign the metatarsal.

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