TY - JOUR T1 - The Pathogenesis of Hallux Valgus AU - Perera, A.M. AU - Mason, Lyndon AU - Stephens, M.M. Y1 - 2011/09/07 N1 - 10.2106/JBJS.H.01630 JO - The Journal of Bone & Joint Surgery SP - 1650 EP - 1661 VL - 93 IS - 17 N2 - The first ray is an inherently unstable axial array that relies on a fine balance between its static (capsule, ligaments, and plantar fascia) and dynamic stabilizers (peroneus longus and small muscles of the foot) to maintain its alignment.In some feet, there is a genetic predisposition for a nonlinear osseous alignment or a laxity of the static stabilizers that disrupts this muscle balance. Poor footwear plays an important role in accelerating the process, but occupation and excessive walking and weight-bearing are unlikely to be notable factors.Many inherent or acquired biomechanical abnormalities are identified in feet with hallux valgus. However, these associations are incomplete and nonlinear.In any patient, a number of factors have come together to cause the hallux valgus. Once this complex pathogenesis is unraveled, a more scientific approach to hallux valgus management will be possible, thereby enabling treatment (conservative or surgical) to be tailored to the individual. SN - 0021-9355 M3 - doi: 10.2106/JBJS.H.01630 UR - http://dx.doi.org/10.2106/JBJS.H.01630 ER -