[Hallux fracture: anatomy, biomechanics, classification, management, and rehabilitation. Narrative review]

fractures of the proximal phalanx of the hallux are among the most common forefoot injuries and are of significant clinical relevance due to their impact on gait biomechanics. These fractures may vary according to the mechanism of injury, the degree of articular involvement, and the associated soft tissue damage. Several therapeutic options are available, including conservative treatment and surgical management using different techniques and implants. Therefore, a review of the English and Spanish language literature published over the last 30 years regarding these fractures was conducted.

to gather the general information available about fractures affecting the proximal phalanx of the hallux, in relation to anatomy, biomechanics, trauma mechanism, clinical evaluation, fracture classification, management options and rehabilitation protocol.

the available literature from 1993 to 2024 was reviewed, including information obtained from textbooks and databases such as PubMed, Cochrane, Embase, Google Scholar, to unify the most important concepts published so far.

traumatic injuries affecting the hallux should be adequately evaluated after figuring out the causal mechanism and do a right radiographic inspection, to rule out fractures or fracture-dislocation, which may require, according to stability or instability criteria, a possible surgical management. Many injuries are susceptible to conservative management, but in selected cases, closed or open reduction with the use of implants may become necessary to reduce the probability of symptomatic and/or functional sequelae.