A Review of the Efficacy of Different Types of Orthoses on Hallux Valgus Angle and Pain Among the People with Hallux Valgus Deformity
Authors: . Rukhsana , Mehra Shivangi , Kataria Chitra 
Published: November 2023

Background: Hallux valgus is a lateral deviation of the great toe, which results in a bony prominence at the MTP joint. It is one of the most prevalent diagnoses affecting up to 23% of women, aged 18 to 65 and around 35% of women over 65 years of age are at risk of developing hallux valgus. It appears that hallux valgus is multifactorial etiology and not yet completely investigated (1). Hallux valgus has been linked with severe toe pain, impaired foot function, difficulty in fitting footwear, and decreased quality of life due to health issues. Several complicated and multifaceted variables can contribute to Hallux valgus, including wearing inappropriate footwear, abnormalities in the anatomy and mechanics of the foot, limb inequality, work-related risks, inflammatory joint disease, and genetics. (4) Due to the first metatarsal & lateral deviation in hallux valgus, the first metatarsophalangeal joint gradually subluxes. Hallux lateral deviation increases hallux valgus angle leading to the rotation of the metatarsals and the metatarsophalangeal joint to experience valgus torque, which pulls the hallux away from its articular surface resulting in pain. (2) For first-line treatment, various conservative options have been suggested, including various kinds of orthoses, splints, and physical therapy. (1)
Objective: The objective of this literature review is to assess the effect of splinting on hallux valgus angle and pain among the individual with hallux valgus deformity.
Study design: Literature Review
Significance: The review was done to investigate the effect of splints or orthoses on hallux valgus angle and associated pain among the individuals with hallux valgus deformity because hallux valgus angle and pain are the main primary factor which are affected in this condition. Thereby reviewing the literature on the hallux valgus angle and pain will provide a clear protocol so that the application of splinting can be incorporated in a more efficient manner.
Method: An electronic database search was conducted using google scholar, science direct, PubMed, Cochrane library and reference list from all the retrieved articles.
Results & discussion: A total 36 research papers were quality rated. After exclusion of the studies without reported measurement reliability for associated factor for hallux valgus angle and pain, data were extracted and analyzed from 15 studies. It was found from the review of data that there was significant improvement in pain after using orthosis. About 8 studies stated significant improvement in hallux valgus angle after the use of orthoses in which type of orthosis used were 3D printed orthosis, toe separator with insole, static &amp; dynamic splints, designed slippers with toe separator and hallufix splint. Whereas one study showed that splint can decrease subjective deterioration of the greater toe in hallux valgus deformity with the use of dynamic splint. Out of 15 studies, 5 studies clearly state that orthosis had no effect on hallux valgus angle.
Conclusion: There is significant correlation between the reduction of the hallux valgus angle and pain intensity after using orthoses for hallux valgus. Toe separator and dynamic orthosis have better outcome results as compared to various other orthoses used for hallux valgus in improving the hallux valgus angle and pain. Thereby orthosis plays an important role as a conservative management by preserving the great toe’s anatomical alignment in hallux valgus deformity.

Key words: hallux valgus, hallux valgus angle, splint, orthoses, pain