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The prevalence of hallux valgus and its relationship to the metatarsal angles have been assessed in South African males from two Black communities and one White community. After the age of 11 years there is a small increase in the metatarsal angle of White males, but this remains within the normal range. In comparison with White females, who seem to be predisposed to the disorder of hallux valgus, neither White nor Black males show a significant increase in hallux angles after adolescence. Males of all ages and race groups seldom develop clinical hallux valgus, and this apparent resistance to the deformity is associated with a minimal increase in the metatarsal angle, and therefore in the width of the foot.

The prevalence of hallux valgus and its relationship to the metatarsal angles and the shape of the foot have been assessed in women over 50 years of age from three populations: an urban White community, an urban Black comunity, and a rural Black community. Hallux valgus was significantly more common in the Whites than in either of the Black groups; there was no significant difference in the prevalence in rural and urban Blacks. Likewise, the angle between the first and second metatarsals was significantly greater in White women (mean 10,80 degrees) than in Black women (mean 8,21 degrees for urban Blacks and 7,05 degrees for rural Blacks). From this study it could be deduced whether the increased metatarsal angle was the cause of the more frequent appearance of hallux valgus in White women.

The prevalence of hallux valgus and its relationship to the metatarsal angles have been assessed in females between the ages of 2 and 20 years in three populations: an urban White community, an urban Black community and a rural Black Community. By the age of 10 years the mean hallux angle is significantly greater in the White girls than in girls in the two Black groups. The angle between the first and second metatarsals is greater in the White than in the black children and this difference increases throughout childhood and adolescence. It is suggested that young White girls may be predisposed to the abnormality of hallux valgus by having significantly greater metatarsal angles.