Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

What happens to the first joint of the large metatarsal in hallux valgus?

1. It aligns with other toes

2. It deviates outward

3. It becomes larger than normal

4. It remains in a neutral position

The correct answer is: It deviates outward

In hallux valgus, the first metatarsophalangeal joint, which is the joint at the base of the big toe, experiences a characteristic deviation. Specifically, the first metatarsal bone shifts laterally, leading to the outward deviation of the big toe (hallux). This outward angle of the hallux relative to the second toe is what most distinctly defines hallux valgus. As the condition progresses, the angle between the first metatarsal and the proximal phalanx of the hallux increases, exacerbating the outward deviation. This lateral shift often causes pain and discomfort, particularly when wearing shoes, and it can result in the formation of a bunion, which is a prominent bump on the side of the foot. The implication is that in hallux valgus, the first metatarsal does not assume a normal position but instead deviates significantly outward, which compounds the issue and affects overall foot alignment and function. Ultimately, this understanding highlights the pathology associated with hallux valgus, focusing on the pronounced lateral deviation that occurs at the first joint of the large metatarsal.