alluce

The alluce is the Italian term for the big toe, the medial-most digit of the foot. In medical English the corresponding term is the hallux, derived from Latin. The hallux is typically the strongest toe and plays a central role in balance and forward propulsion during walking.

Anatomy and function: The alluce usually has two phalanges (proximal and distal) connected to the first metatarsal by the first metatarsophalangeal joint. It bears a substantial share of body weight during stance and provides a lever for push-off in the propulsive phase of gait. Its alignment and mobility affect foot mechanics, balance, and shoe fit.

Common conditions and variations: The most frequent deformity is hallux valgus, also known as a bunion, where the big toe drifts toward the other toes and the first metatarsal angles inward. Hallux rigidus refers to degenerative arthritis of the first MTP joint, causing pain and reduced motion. Other issues include hallux varus (inward turning), sesamoid pain, and various malalignments influenced by genetics, foot structure, or ill-fitting footwear.

Diagnosis and treatment: Diagnosis is based on clinical examination and imaging, typically X-rays, to assess toe alignment and joint condition. Conservative management includes properly fitted footwear, padding, orthotics, and anti-inflammatory medications. When deformities cause pain or functional limitation, surgical options may be considered, such as bunionectomy with osteotomy to realign the bones, or arthrodesis or joint replacement for severe arthritis.