Hallux purchase:
Have patient weightbear with a piece of paper under the hallux – attempt to withdraw the paper distally to determine weightbearing of hallux.
Can be done passively and actively to evaluate first MPJ function
• Good/normal – if it is difficult to remove the paper
• Fair – can remove paper when subject is passive but not when patient actively resists
• Poor – can remove paper when subject is passive but not when patient actively resists, but resistance is only via interphalangeal joint plantarflexion
• Absent – can remove paper when patient passive and actively resists
Clinical use:
• post- and pre-operative evaluation of hallux-abducto valgus
• loss of hallux purchase may be associated with increase lessor metatarsal head weightbearing
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