The intermetatarsal angle (IMA) in hallux valgus represents the angle between the first and second metatarsal shafts. A hallux valgus angle (HVA) of 30° and an IMA of 16° would be classified as:

• A Mild hallux valgus — suitable for conservative treatment only
• B Moderate hallux valgus — distal chevron or Scarf osteotomy indicated
• C Normal — no intervention required
• D Severe hallux valgus — proximal osteotomy or Lapidus procedure indicated ✓

Explanation

Hallux valgus severity: mild = HVA <20°, IMA <11°; moderate = HVA 20–40°, IMA 11–16°; severe = HVA >40°, IMA >16°. An IMA of 16° and HVA of 30° (borderline severe) indicates significant metatarsus primus varus that cannot be corrected by distal osteotomy alone; a proximal metatarsal osteotomy (e.g., proximal crescentic, opening wedge) or Lapidus (first tarsometatarsal arthrodesis) is needed to correct the increased IMA.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.