- Discussion:
- hyperpronation, by virtue of its mechanics, inevitably results in
hallux being forced into valgus even in absence of
RA dz
in first metatarsal joint;
- in this situation fusion of first MP joint is preferred option;
- this does not apply when there is severe forefoot disease;
- where foot has collapsed into pronated valgoid position, requirements
are multiple;
- heel is no longer under leg, midfoot is twisted, often to extent that
talar head starts to bear wt medially, & gait becomes
flat footed
with the loss of the anterior rocker;
- Treatment:
- simple medial translational calcaneal osteotomy can help put load
bearing area of heel back under loadbearing line of leg;
- this may relieve the pain due to turning moments generated in ankle-
subtaloid complex on wt bearing;
