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What happened to the A in HAV ?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by mike weber, Mar 28, 2010.

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    I´m sure there is a very good reason for it but it makes no sense to me why Hallux abductovalgus is referred to as Hallux Valgus.

    When ever I´ve taught students and they are discussing biomechanics of another person, I always tell them to think that I´m on the other end of a phone. By using the correct medical language I will get the foots biomechanical picture etc.

    So take Hallux abductovalgus, the term tells me Hallux is in an abducted, Valgus position.

    Hullax Valgus tells me Hullax and Valgus nothing more why is the abducted generally assumed? there maybe a adducted position etc.

    Maybe I just getting grumpy as my years increase. I did yell at the TV last night when a car tire claimed to reduce your fuel intake by 80 L with new tires, I yelled "over how long? 50 years" I think that maybe the 1st sign of Grumpy Old Man Syndrome.

    But what happen to the abducto ?
  2. Actually "hallux abducto valgus" is a relatively new term, the majority of historical and particularly orthopaedic literature refers to hallux valgus, not hallux abducto valgus. Moreover, what does "abducto" mean? Abducted, abduction... There's some room for confusion too, abducted in relation to the midline of the body, adducted in relation to the midline of the foot. Call me old fashioned, I prefer hallux valgus as defined by Hueter (1871), who invented the term "hallux valgus" to describe "an abduction contracture" of the great toe.
  3. That would be the good reason then, Thanks Simon.
  4. Cameron

    Cameron Well-Known Member


    The term Hallux Valgus was orignially used in orthopaedic nomenclature to describe lateral deviation of the hallux. Valgus then referred to single plane abduction as in the term pes valgus. Only much later did the term describe fixed plane eversion and hence the confusion.

    We now know HAV describes a triplane subluxation at the MPJ. As a result of the pathology the proximal phalanx of the hallux is abducted against the metatarsal head (old term valgus); externally rotated over the net head i.e everted to the metatarsal head (new term valgus); and dorsiflexed to the met head i.e. articukating over the upper quadrant of the articulating surface of the met head.

    The combination of abduction, eversion and dorsiflexion at the MPJ (di-plane plane joint) describes pronation. To be anatomilcally accurate the condition should be described as subluxated Hallux Pronatus. Not only is this anatomically accurate it also cement the primary causation of the pathology i.e. triplane disarticulation of the kinetic foot.

  5. drsarbes

    drsarbes Well-Known Member

    I just think it's too much of a mouthful to say the entire medical term. In fact Bunion is even easier!

    In addition, it is quite an old term that doesn't really relate well to the actual pathology (i.e., metatarsal primus adductus); more of a term coined relative to the clinical observation.

    I have some more:

    The cola in Pepsi cola
    The Christmas in Happy Holiday
    The Warming in global climate change
    The Young in Young Dr. Arbes


  6. For those who don't understand Cameron's new words:

    Net head: The people in the deli that have half of their hair hanging out of their hair nets.....falling into the food they are making for you.

    Articukating: What happens when an artichoke leaf gets stuck in your throat because you thought they were edible.

  7. David Smith

    David Smith Well-Known Member

    Yeah, "The Young in Young Dr. Arbes" like that, I've noticed that too:mad:

    And what happened to all the vowels when American actors say mirror (look in the mrrr).

    What happened to the meat in Spam?

    And do Italians (and Greeks) find medical nomenclature really easy? to them Hallux abducto valgus is like us saying as his big toe is bent out a bit.

  8. markjohconley

    markjohconley Well-Known Member

    And I thought that 'valgus' was the odd one in HAV!

    Keep floggin' it Steve!
  9. drsarbes

    drsarbes Well-Known Member

    Dave: I happen to be Greek- Italian.
    I guess it would have helped if I spoke GREEK or ITALIAN!
    Maybe I should have had my parents help me with my homework! haha



    (that would be BYE in Greek - and what every happen to the Good in Good Bye?)
  10. Cameron

    Cameron Well-Known Member


    Combination of slight dyslexia, nystagmous and a sticky keyboard do leave the odd word or two. So I can only aplogise but thank Kevin for doing the translation. I do envy perfection in others.

    I am slightly surprised however to read how dismissive some have been so far in this thread as to the use of proper nomenclature in the description of a common foot pathology.

    In his original post Mike makes a serious statement which deserves a considered response. Me thinks.

    "By using the correct medical language I will get the foots biomechanical picture etc."

    What am I missing?

  11. I think it depends on the target audience. If you were speaking with a G.P. they would be familiar with the term hallux valgus, but probably not hallux abducto valgus, if you were speaking to the lay public, "bunion" might be within their understanding, while hallux valgus may not.
  12. Mark_M

    Mark_M Active Member

    A recent physio gradute told me they were taught when describing anatomical direction/position of the foot they take it from the midline of the foot bisecting the 2nd metatarsal, rather than the midline of the body.

    There fore in regards to the hallux : medial becomes lateral; and abduction becomes adduction.
    If this really is the case i could live withaout the 'A' in Hallux Valgus
  13. Mark, take a look at the abductor hallucis muscle...
  14. NeedingMassage

    NeedingMassage Active Member

    Just when I thought I'd figured it out.

    Achilles is a greek god.

    Is 'Aducto' the middle name of another god of podiatry, or not?

    Is 'Rigidus' a sibling, and if so, how often should the lay person prostrate themselves for worship?
    Last edited: Apr 2, 2010
  15. HansMassage

    HansMassage Active Member

    I never found valgus and vargus helpful anatomical references. Er had to learn them because the Dr.'s referral might use them.

    What I want to know is the subluxated Hallux due to a hypertonic extensor or dorsa flexor or somthing else. Or dose the Dr. need me to figure that out?

    Hans Albert Quistorff, LMP
    Antalgic Posture Pain Specialist
  16. NewsBot

    NewsBot The Admin that posts the news.

    Hallux valgus, hallux varus and
    metatarsus adductus terms are misnomers

    Kush Kumar
    Anatomy 2014;8: (Full text)

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