A constant structural eversion of the forefoot. This is a structural or positional deformity that is most common in the forefoot.
This is an everted position of the forefoot relative to the rearfoot at the level of the midtarsal joint. Inversion of the lateral column of the foot must occur to allow the forefoot to propel the supporting surface during the midstance and propulsive phases of gait.
The two forms of forefoot valgus are:
- Flexible Forefoot Valgus: There is sufficient flexibility in the midtarsal joint to allow the lateral column of the foot to reach the supportive surface during the stance phase of gait. The heel may function perpendicularly, but the amount of compensation that occurs leads to an unstable gait with late pronation through midstance into propulsion.
- Rigid Forefoot Valgus: When the range of motion in the mid-tarsal joint is not enough to allow the lateral column of the foot to touch the ground, rearfoot supination/compensation is required. This is rarely seen clinically.
Clinical observations and symptoms:
- Lateral heel callus
- Intractable plantar keratoma 1, 5
- Hammer toes
- Plantar fasciitis
- Lateral ankle pain
This is an extremely rare biomechanical presentation. It is associated with severe tibial valgum (knock knees) and excessive subtalar pronation.