Hallux valgus
Meaning of hallux valgus: For the purposes of this Statement of Principles: hallux valgus means a symptomatic deformity of the foot, where the great toe is deviated laterally at the first metatarsophalangeal joint, and often causing a bony prominence or bunion to develop over the medial aspect of the first metatarsal head and neck.
Reasonable Hypothesis (RH) — Statement of Principles No. 25 of 2024
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting hallux valgus or death from hallux valgus with the circumstances of a person's relevant service:
- (1)wearing footwear that causes substantial lateral deviation of the great toe of the affected foot, for at least 7 hours per day, on more days than not for a period of at least 18 months before the clinical onset or clinical worsening of hallux valgus;
- (2)having rheumatoid arthritis involving the first metatarsophalangeal joint of the affected foot before the clinical onset or clinical worsening of hallux valgus;
- (3)having gout or calcium pyrophosphate deposition disease (also known as pseudogout) involving the first metatarsophalangeal joint of the affected foot before the clinical onset or clinical worsening of hallux valgus;
- (4)having pes planus of the affected foot before the clinical worsening of hallux valgus;
- (5)having acquired loss of one or more of the phalanges of the second toe or the second metatarsal head of the affected foot, before the clinical onset or clinical worsening of hallux valgus;
- (6)having a tumour involving the first metatarsophalangeal joint or second metatarsal bone of the affected foot at the time of the clinical onset or clinical worsening of hallux valgus;
- (7)having trauma to the affected forefoot that results in: (a) disruption of the first metatarsophalangeal joint capsule; (b) disruption of the sesamoid complex of the hallux; (c) fracture of the medial side of the first proximal phalanx base; (d) fracture resulting in shortening of the second metatarsal; (e) tarso-metatarsal joint complex injury; or (f) tear of the medial collateral ligament of the first metatarsophalangeal joint; within the 5 years before the clinical onset or clinical worsening of hallux valgus;
Note: trauma to the affected forefoot is defined in the Schedule 1 - Dictionary.
- (8)inability to obtain appropriate clinical management for hallux valgus before the clinical worsening of hallux valgus;
Balance of Probabilities (BoP) — Statement of Principles No. 26 of 2024
7 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, hallux valgus or death from hallux valgus is connected with the circumstances of a person's relevant service:
- (1)wearing footwear that causes substantial lateral deviation of the great toe of the affected foot, for at least 7 hours per day, on more days than not for a period of at least 3 years before the clinical onset or clinical worsening of hallux valgus;
- (2)having rheumatoid arthritis involving the first metatarsophalangeal joint of the affected foot before the clinical onset or clinical worsening of hallux valgus;
- (3)having gout or calcium pyrophosphate deposition disease (also known as pseudogout) involving the first metatarsophalangeal joint of the affected foot before the clinical onset or clinical worsening of hallux valgus;
- (4)having acquired loss of one or more of the phalanges of the second toe or the second metatarsal head of the affected foot, before the clinical onset or clinical worsening of hallux valgus;
- (5)having a tumour involving the first metatarsophalangeal joint or second metatarsal bone of the affected foot at the time of the clinical onset or clinical worsening of hallux valgus;
- (6)having trauma to the affected forefoot that results in: (a) disruption of the first metatarsophalangeal joint capsule; (b) disruption of the sesamoid complex of the hallux; (c) fracture of the medial side of the first proximal phalanx base; (d) fracture resulting in shortening of the second metatarsal; (e) tarso-metatarsal joint complex injury; or (f) tear of the medial collateral ligament of the first metatarsophalangeal joint; within the 3 years before the clinical onset or clinical worsening of hallux valgus;
Note: trauma to the affected forefoot is defined in the Schedule 1 - Dictionary.
- (7)inability to obtain appropriate clinical management for hallux valgus before the clinical worsening of hallux valgus;
