Primary osteoarthritis of the metatarsophalangeal (MP) joint of the great toe often commences in adolescence and gives rise ultimately to pain and stiffness in this joint. It is commoner in males, and is not associated with hallux valgus. Sometimes the toe is held in a flexed position (hallux flexus), and the proximal phalanx and metatarsal head are thickened following joint narrowing and circumferential exostosis formation. Treatment is usually by fusion or Keller's arthroplasty.
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