L-shaped deformity of the great toe in children

L-shaped deformity of the great toe in children

Unlike the more commonly discussed condition of hallux valgus, hallux valgus interphalangeus (HVI) has received relatively little attention in the foot and ankle literature. In HVI, the distal phalanx is internally rotated compared to the proximal phalanx. This abnormality typically presents in early childhood and may progress rapidly during growth spurts. 

Potential causes of HVI include obliquity of the articular surface of the proximal phalangeal head and an asymmetrical distal phalanx. The deformity involves a deviation of the articular surfaces of the interphalangeal joint, with lateralization of the insertion of the extensor hallucis longus (EHL) tendon identified as another contributing factor. Treatment options include surgical correction of the proximal phalanx or fusion of the interphalangeal joint. Arthrodesis of the interphalangeal joint provides more reliable long-term results compared to osteotomy in moderate cases of the deformity following skeletal maturity.

Hallux valgus interphalangeus represents a complex deformity involving both joint articulation and surrounding soft tissue. Early surgical intervention is recommended due to the potential for rapid progression of the deformity. Arthrodesis of the interphalangeal joint is preferred for achieving reliable and durable correction, particularly in cases where the deformity is severe and inflexible.

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