Helical Nail Case Study

Patient History: The patient is a 59-year-old female with long standing pain with shoe wear despite attempts at extra width shoes and orthotics. The deformity has worsened over the last two years and she is currently unable to wear any shoes other than tennis shoes. On physical examination, the hallux is abducted and the distal end of the metatarsal head is prominent. While the second toe is slightly elevated, she notes no symptoms referable to this digit. She is tender on the medial first metatarsal head prominence and the area is reddened and swollen. Radiographs of the foot show a hallux valgus deformity with mild lateral subluxation of the proximal phalanx on the metatarsal head with a prominent medial eminence.