Hallux Valgus and Forefoot Surgery brings together a group of physicians interested in the care of the foot who unselfishly share their experience, expertise, and knowledge with those of similar interest. Deformities of the forefoot are complex, causing varying degrees of pain and suffering. Such deformities also contribute to overall functional disability in many patients suffering from the variety of deformities affecting the foot. This is especially true of older patients for whom mobility equates with independence.
This book addresses the clinical aspects of deformity of the forefoot, focusing primarily on hallux valgus. Presented in separate chapters are the anatomy of the forefoot, biomechanics of the hallux valgus deformity, and clinical and radiographic evaluation of the forefoot. These initial chapters are then followed by a series of chapters on procedures for the management of hallux valgus; these chapters address criteria for procedure selection based on clinical, radiographic, and biomechanical foundations. They include soft tissue procedures, phalangeal, distal, and proximal metatarsal osteotomy, and procedures involving the cuneiform. Each addresses a specific type of procedure in detail including indications and complications. Some repetition of material may occur in several of the chapters; this was done to allow for completeness of presentation of the material in the individual chapters and to reinforce some of the radiographic, biomechanical, and other principles relative to the specific procedures described. The terms hallux valgus and hallux abducto valgus have been used interchangeably throughout the text and for practical purposes refer to the same deformity.
The text would not be complete without addressing other deformities associated with hallux valgus that accompany the painful forefoot. These include hallux limitus and rigidus, hallux varus, nail and digital deformity, metatarsalgia, as well as neuroma and nerve entrapment syndromes. Separate chapters deal with management of diabetic and rheumatoid patients. An international perspective is added to demonstrate the similarity and diversity of the approaches to the management of hallux valgus. It is my hope that this text will become a useful resource to students, residents, and practitioners.
I would like to thank all of the contributing authors for their generous commitment of time, knowledge, and patience; it is for this reason that I dedicate the book to them.
I would also like to acknowledge the contributions made by Joan Lannoch for her art work, Donna Perzeski, who was invaluable with her library research assistance and Marsha Deetz for her assistance in producing this electronic form of the text.
Vincent J. Hetherington, D.P.M., M.S.