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In regard to the typical hyperkeratotic lesion on medial side of IPJ of a valgus rotated (frontal plane) hallux, of a hallux abducto-valgus complex.
My understanding is that it results from both the abducted (TP) and the valgus (FP) alignment of the hallux.
Can either or both be 'corrected' by biomechanical intervention in an elderly (over 70 y/o) patient with mild (45 deg of passive dorsiflexion) bilateral hallux limitus.
An example of same has been attaining podiatry / wound care for at least 6/12 with, apparently, little improvement.
Thanks, mark

 

This sounds like the classic functional hallux liimitus. There is range of motion in the direction of dorsiflexion. There must be a pretty significant plantar flexion moment acting on the hallux in gait to create the "pinch callus". One source of plantar flexion moment on the hallux is the windlass mechanism.

Yes, this lesion occurs on the medial side of the hallux because it is rotated. However, if there was no resistance the toe would dorsiflex in response to ground reaction force in this location. However, there is resistance to dorsiflexion of the hallux.

So, a device designed to reduce tension in the windlass should help.

Regards,

Eric

 

Thanks Eric, your opinion is appreciated, and it will convince the 'nay-sayers', mark