Factors Related to the Etiology of Hallux Abducto Valgus: A Systematic Review

Background: The origin of hallux abducto valgus (HAV) is considered to be multifactorial; however, evidence regarding the factors involved in its development is scattered and often contradictory. Understanding the factors that contribute to the onset of HAV is crucial for informing both prevention a...

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Detalhes bibliográficos
Autores: Moreno-Fresco, Marta María, Mizzi, Stephen, Munuera Martínez, Pedro Vicente, Távara Vidalón, Priscila
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Recursos:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:dnet:idus________::5f6ae81ed684b7e83c3e72124e70ac8c
Acesso em linha:https://hdl.handle.net/11441/184459
https://doi.org/10.3390/jfmk11010117
Access Level:acceso abierto
Palavra-chave:Hallux valgus
Etiology
Inheritance
Foot
First ray
Descrição
Resumo:Background: The origin of hallux abducto valgus (HAV) is considered to be multifactorial; however, evidence regarding the factors involved in its development is scattered and often contradictory. Understanding the factors that contribute to the onset of HAV is crucial for informing both prevention and clinical management strategies. This review aims to explore the etiological factors associated with the development of HAV. Methods: A literature search was conducted in PubMed, Embase, Web of Science and Scopus. The search included observational studies that investigated etiological or risk factors related to the development of HAV. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklists, and the level of evidence was classified according to the Oxford Centre for Evidence-Based Medicine (OCEBM). Results: A total of 36 observational studies (20 cross-sectional and 16 case–control) were included, involving 14,500 participants, predominantly females. Genetic evidence indicated strong familial aggregation and variants in collagen- and extracellular matrix-related genes as potential hereditary determinants. The most consistent biomechanical factors were first-ray hypermobility, abnormal foot pronation and reduced activity of the abductor hallucis muscle. Additionally, female sex, older age and prolonged use of narrow or inadequate footwear were identified as recurring predictive variables. Overall, the findings support a complex etiological model based on the interaction of intrinsic and extrinsic factors. Conclusions: The development of HAV appears to be determined by the interaction of genetic, structural and biomechanical factors that alter first-ray stability and forefoot function. Current evidence supports a multifactorial etiological model with a strong hereditary component and higher susceptibility in women. Longitudinal studies employing standardized methods are needed to establish causal relationships and quantify the relative contribution of each factor.