Great Toe Anatomy

Review Article

Austin J Anat. 2021; 8(2): 1100.

Great Toe Anatomy

King MA, Vesely BD* and Teasdall RD

Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston Salem, NC, USA

*Corresponding author: Bryanna D Vesely, Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Oakwood Ct. Winston Salem, NC, 27103, USA

Received: July 15, 2021; Accepted: July 24, 2021; Published: July 31, 2021


In conclusion, hallux abductovalgus is a common deformity of the forefoot that has complex implications on the biomechanics and gait of patients. Understanding the anatomy and physiology behind this deformity is essential when creating conservative and surgical treatment plans.

Keywords: Anatomy; Hallux; Great toe; Toot; Podiatry; Sesamoid; Bunion; Hallux valgus


Anatomy is the foundation of medicine. It is the first subject taught in medical training and it creates the groundwork for advanced physiology and pathology. When diagnosing and treating a patient, it is essential to have an advanced knowledge base of anatomy in order to correctly reach a diagnosis. Due to the complexity of the first ray structure, it can be difficult to accurately diagnose and treat this part of the body. Therefore, it is important for practitioners of any level to review human anatomy. The purpose of this article is to review great toe anatomy and its most common deformity: hallux abductovalgus.

Hallux abductovalgus is the most common forefoot pathology in adults. Nix et al performed a systematic review and meta-analysis estimating hallux valgus prevalence in 23% of adults aged 18-65 and 36.7% in elderly people over the age of 65 [1]. Hallux valgus has a predilection for women; as high as 15:1 in some studies [1]. It can be defined as a progressive deformity beginning with a lateral deviation of the great toe, medial deviation of the first metatarsal, and progressing to first metatarsophalangeal subluxation [3]. Previous studies have shown a genetic correlation, finding that up to 90% of patients with painful hallux abductovalgus deformities have some family members with a similar deformity [2]. Other causes of hallux valgus include restrictive foot wear, neuromuscular disorders, and other foot deformities such as pes planus, equinus, and ligament laxity [3].

Symptoms for hallux valgus include pain, wearing shoes with narrow toe boxes, pain at the medial eminence of the first metatarsal, and pain during weight bearing. With progression of the deformity, patients may have pain during range of motion of the first metatarsophalangeal joint, pain during rest, and decreased range of motion at the 1st metatarsophalangeal joint. Conservative treatments include wide toe box shoes, orthotics, and toe padding. Surgical treatment is complex and chosen based on the complexity of the deformity and the goals of the patient. For less severe deformities, more distal procedures can be performed while proximal osteotomies are done for severe deformities. There is estimated to be more than 150 different hallux abductovalgus procedures [4]. It is essential to understand the great toe anatomy when performing hallux abductovalgus procedures in order to understand the biomechanical impacts of the foot and chose the proper surgery.


The great toe includes five bones: the first metatarsal, proximal phalanx, distal phalanx, tibial sesamoid, and fibular sesamoid (Figure 1).