Toe Deformities: Bunion (Hallux Valgus), Hammer Toe & Rehab

Deformities of the Toes

Toe deformities are common problems, often caused by improper footwear (narrow toe box) or muscle imbalance.

1. Hallux Valgus (Bunion)

• Definition: Lateral deviation of the Great Toe > 15 degrees.
• Bunion: Inflamed bursa over the medial eminence of the 1st metatarsal head.
• Management: Wide shoes, spacers. Surgery (Osteotomy e.g., Scarf/Chevron) if painful.

2. Lesser Toe Deformities

Distinguishing the Deformities:
- Hammer Toe: PIP Flexion + DIP Extension (MTP Extension). Common in 2nd toe.
- Claw Toe: MTP Extension + PIP Flexion + DIP Flexion. (Intrinsic minus foot).
- Mallet Toe: Isolated DIP Flexion.

25 Practice MCQs

Q1. Hallux Valgus is defined as a valgus angle greater than:

Answer: A). Normal is < 15.

Q2. A Bunion is:

Answer: A). Caused by friction.

Q3. Hammer Toe involves:

Answer: A). "Hammer" shape.

Q4. Claw Toe is typically caused by:

Answer: A). e.g., Diabetes, Charcot-Marie-Tooth.

Q5. Mallet Toe involves:

Answer: A). Often hits end of shoe.

Q6. Which is a common surgical procedure for Hallux Valgus?

Answer: A). Realigns the metatarsal.

Q7. Conservative management includes:

Answer: A). Relieves pressure.

Q8. Bunionette (Tailor's Bunion) occurs on the:

Answer: A). Small toe bunion.

Q9. Hallux Rigidus is:

Answer: A). Limited dorsiflexion.

Q10. Cheilectomy is used to treat:

Answer: A). Improves range of motion.

Q11. Keller's Arthroplasty (Resection) is reserved for:

Answer: A). Causes loss of push-off power ("Floppy toe").

Q12. Hallux Valgus is more common in:

Answer: A). High heels and narrow toe boxes.

Q13. Metatarsalgia refers to:

Answer: A). Often due to loss of transverse arch.

Q14. The "Girdlestone-Taylor" procedure (Flexor to Extensor transfer) treats:

Answer: A). Rebalances the muscles.

Q15. Morton's Neuroma is:

Answer: A). "Mulder's Click" test.

Q16. Soft Corns (Heloma Molle) occur:

Answer: A). Hard corns are on top.

Q17. Arthrodesis of the 1st MTP joint is the gold standard for:

Answer: A). Eliminates pain reliably.

Q18. Akin Osteotomy is performed on the:

Answer: A). To correct Hallux Valgus Interphalangeus.

Q19. Congenital Hallux Varus is:

Answer: A). Opposite of Valgus.

Q20. Lapidus procedure involves:

Answer: A). For hypermobile first ray.

Q21. Hallux Valgus angle is normal if:

Answer: A).

Q22. Intermetatarsal Angle (IMA) > 9 degrees suggests:

Answer: A). The metatarsal deviates medially.

Q23. Crossover Toe is usually:

Answer: A). Instability of 2nd MTP.

Q24. Surgical correction of Hammer toe usually involves:

Answer: A). Straightens the toe permanently.

Q25. Freiberg's Infarction is:

Answer: A). Causes pain and stiffness.