Hallux valgus and hammer toe.

An elderly woman was observed after hip surgery to start a rehabilitation program; physical examination revealed a lush hallux valgus, however no complaints were reported. Hallux valgus is a frequent forefoot deformity; global prevalence is 35% in those over 65 years-old.1 Women are more affected; deformity is normally attributed to ill-fitting shoes.1 Imbalance of the extrinsic/intrinsic foot muscles and ligaments is involved in pathogenesis.1 Symptoms include pain in the bunion, hammer or claw toe, and metatarsalgia.1 An angle (> 15°) between the longitudinal axes of the first metatarsal and the proximal phalanx of the hallux with the vertex at the head of the first metatarsal confirms the diagnosis.1 Adequate correction isn’t possible in the elderly and conservative treatment is restricted to symptoms relief.1 Surgical treatment is indicated when maintained pain impairs foot function and should be followed by a rehabilitation program, usually with full load bearing in a flat orthopedic shoe.1