[Therapy of pediatric hallux valgus]

Hallux valgus deformities in children and adolescents are attributed to various malformations. Meticulous assessment of clinical and radiological findings as well as age-dependent progress of hallux malalignment has to be taken into consideration to work out an individual therapeutic concept. Conservative treatment includes both night splints and exercises. Surgical therapy has to be strictly based on objective criteria, i.e. the size of the first intermetatarsal angle and correction of the distal metatarsal articular angle. Moderate deformities can be corrected with three-dimensional distal metatarsal osteotomy. Severe hallux valgus deformities often require a double metatarsal osteotomy to address the intermetatarsal angle and the distal metatarsal articular angle. In cases of additional hallux valgus interphalangeus further osteotomy of the proximal phalanx (triple osteotomy) is necessary.