Hallux Angles: A new medical software for smartphone for data archiving and angular measurements of foot operated for hallux valgus. Study and discussion on the software reliability

2014 ◽  
Vol 30 (2) ◽  
pp. 57-61
Author(s):  
O. Catani ◽  
G. Casburo ◽  
G. Trinchese ◽  
G. Iervolino ◽  
G. Natrucci ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Software Reliability ◽  
Data Archiving ◽  
Medical Software ◽  
Angular Measurements

Foot Mobilization and Exercise Program Combined with Toe Separator Improves Outcomes in Women with Moderate Hallux Valgus at 1-Year Follow-up

2018 ◽  
Vol 108 (6) ◽  
pp. 478-486 ◽  
Author(s):  
Sahar Ahmed Abdalbary
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Hallux Valgus ◽  
Outcome Measures ◽  
Mixed Model ◽  
Exercise Program ◽  
Angular Measurements ◽  
Foot Joint ◽  
Abduction Strength

Background: Few studies have documented the outcome of conservative treatment of hallux valgus deformities on pain and muscle strength. We sought to determine the effects of foot mobilization and exercise, combined with a toe separator, on symptomatic moderate hallux valgus in female patients. Methods: As part of the randomized clinical trial, 56 women with moderate hallux valgus were randomly assigned to receive 36 sessions for 3 months or no intervention (waiting list). All patients in the treatment group had been treated with foot joint mobilization, strengthening exercises for hallux plantarflexion and abduction, toe grip strength, stretching for ankle dorsiflexion, plus use of a toe separator. Outcome measures were pain and American Orthopedic Foot and Ankle Society (AOFAS) scores. Objective measurements included ankle range of motion, plantarflexion and abduction strength, toe grip strength, and radiographic angular measurements. Outcome measures were assessed by comparing pretreatment, posttreatment, and 1-year follow-up after the intervention. Mixed-model analyses of variance were used for statistical assessment. Results: Patients who were treated with 3 months of foot mobilization and exercise combined with a toe separator experienced greater improvement in pain, AOFAS scores, ankle range of motion, hallux plantarflexion and abduction strength, toe grip strength, and radiographic angular measurements than those who did not receive an intervention 3 months and 1 year postintervention (P < .001 for all comparisons). Conclusions: These results support the use of a multifaceted conservative intervention to treat moderate hallux valgus, although more research is needed to study which aspects of the intervention were most effective.

Hallux Valgus in Men Part II: First Ray Mobility after Bunionectomy and Factors Associated with Hallux Valgus Deformity

2003 ◽  
Vol 24 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Michael J. Coughlin ◽  
Paul S. Shurnas
Keyword(s):  
Hallux Valgus ◽  
Positive Family History ◽  
Valgus Deformity ◽  
Ankle Dorsiflexion ◽  
Metatarsal Osteotomy ◽  
Pes Planus ◽  
Hallux Valgus Deformity ◽  
First Ray ◽  
Angular Measurements ◽  
Standard Radiographs

Methods: A retrospective study of 30 men (35 feet) was performed. First ray mobility, ankle dorsiflexion, pes planus, and metatarsus adductus were evaluated at the final follow-up. All internal fixation was routinely removed at six to eight weeks postoperatively. Standard radiographs were evaluated and angular measurements were calculated on all feet. Conclusion: Hallux valgus in this group of male patients was not associated with limited ankle dorsiflexion or pes planus. Men with toe pronation and a positive family history had a greater hallux valgus deformity than those without after a distal soft tissue repair with proximal first metatarsal osteotomy. There was no evidence of first ray hypermobility after a DSTP-PMO.

Radiographic Angles in Hallux Valgus: Differences Between Measurements Made Manually and With a Computerized Program

2006 ◽  
Vol 27 (3) ◽  
pp. 175-180 ◽  
Author(s):  
Carlos Piqué-Vidal ◽  
Ignaci Maled-García ◽  
Juanjo Arabi-Moreno ◽  
Joan Vila
Keyword(s):  
Hallux Valgus ◽  
Measurement Techniques ◽  
Intraclass Correlation ◽  
Intermetatarsal Angle ◽  
Mean Values ◽  
Angle Measurements ◽  
Valgus Angle ◽  
Angular Measurements ◽  
San Rafael ◽  
True Values

Background: The objective of this study was to compare angular measurements in the evaluation of hallux valgus deformities using a goniometer and a computerized program to assess degree of concordance between the two methods and determine the reliability of manual measurements. Methods: Angles measured included the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the distal metatarsal articular angle (DMAA), and the proximal phalangeal articular angle (PPAA), also called the hallux valgus interphalangeus angle or interphalangeal angle. Measurements were made on preoperative weightbearing radiographs in 176 patients with symptomatic hallux valgus. Manual measurements were made with a goniometer by an orthopaedic surgeon. An independent experienced technician used digitized images to perform angular measurements with the Autocad® software program (Autodesk Inc., San Rafael, CA). Results: HVA values obtained with the two techniques were similar. However, significantly higher mean values were obtained with the Autocad® for the IMA and PPAA measurements, and higher mean values were obtained for the DMAA measurement with the manual technique. Whereas differences were more or less randomly distributed for the HVA, in the remaining patients, measurements were clearly related to the measurement technique, i.e., for the DMAA, the manual technique had a tendency to show higher values, and for the IMA and PPAA the manual technique showed lower values than the computer. Correlations between both techniques for the different angular measurements were as follows: HVA, −0.179 ( p = 0.018); DMMA, −0.294 ( p >0.001); PPAA, −0.876 ( p >0.001); and IMA, −0.661 ( p >0.001). The intraclass correlation coefficient (ICC) showed that the concordance between manual and Autocad® angular measurements was excellent for the HVA ( ICC = 0.89) and DMAA ( ICC = 0.80) and very poor for the PPAA ( ICC = 0.11) and IMA ( ICC = 0.42). Conclusions: Angular measurements made on weightbearing radiographs with the Autocad® in patients with hallux valgus deformities were more reliable than those made with a goniometer. Although for large angles, such as HVA and DMAA, results obtained with both measurement techniques were similar. Manual measurements, however, may underestimate the true values of the smaller IMA and PPAA angles.

The Reliability of Angular Measurements in Hallux Valgus Deformities

2001 ◽  
Vol 22 (5) ◽  
pp. 369-379 ◽  
Author(s):  
Michael J. Coughlin ◽  
Elisha Freund
Keyword(s):  
Hallux Valgus ◽  
Valgus Deformity ◽  
Hallux Valgus Angle ◽  
Observer Reliability ◽  
Hallux Valgus Deformity ◽  
Metatarsal Angle ◽  
Valgus Angle ◽  
Wide Range ◽  
Angular Measurements ◽  
Minimum Interval

The purpose of this study was to determine the intra-observer and inter-observer reliability of physicians on a repetitive basis in making angular measurements of hallux valgus deformities. The hallux valgus angle, the 1–2 intermetatarsal angle, and the distal metatarsal articular angle and the assessment of congruency/subluxation of the first MTP joint were evaluated on a repetitive basis. Physicians were provided with a series of black and white photographs of radiographs with a hallux valgus deformity. Three different sets of photographs randomly ordered were sent at a minimum interval of six weeks to the participants. Participating physicians were extremely reliable in the measurement of the 1–2 metatarsal angle. 96.7% of the photographs were repeatedly measured within a range of 5 degrees or less. The angular measurements to determine the hallux valgus angle were slightly less reliable, but 86.2% of photos were repeatedly measured within a range of 5 degrees or less. In the measurement of the distal metatarsal articular angle, 58.9% of photographs were repeatedly measured within a range of 5 degrees or less. There was a wide range within physician evaluators who recognized very few congruent joints (2 of 21) and those who recognized several congruent joints (11 of 21). Most physicians appeared to be internally consistent in the assessment of MTP congruency; however, some photographs were much more difficult to assess than others. This study validates the reliability of the measurement of the hallux valgus and the 1–2 metatarsal angle. The inter-observer reliability in the measurement of the distal metatarsal articular angle is questioned.

Interobeserver and Intraobserver Reproducibility of Hallux Valgus Angular Measurements and the Study of a Linear Measurement

2012 ◽  
Vol 5 (6) ◽  
pp. 374-377 ◽  
Author(s):  
Jose Veiga Sanhudo ◽  
Joao Ellera Gomes ◽  
Marcelo Costa Rabello ◽  
Giuseppe Delucca
Keyword(s):  
Hallux Valgus ◽  
Linear Measurement ◽  
Intraobserver Reproducibility ◽  
Angular Measurements

Intra- and Inter-observer Reliability of the Distal Metatarsal Articular Angle in Adult Hallux Valgus

2002 ◽  
Vol 23 (8) ◽  
pp. 722-726 ◽  
Author(s):  
Thomas D. Chi ◽  
James Davitt ◽  
Alastair Younger ◽  
Sarah Holt ◽  
Bruce J. Sangeorzan
Keyword(s):  
Hallux Valgus ◽  
Kappa Statistic ◽  
Weighted Kappa ◽  
P Value ◽  
Hallux Valgus Angle ◽  
Joint Congruency ◽  
Observer Reliability ◽  
Valgus Angle ◽  
First Ray ◽  
Angular Measurements

There is some uncertainty as to whether the distal metatarsal articular angle (DMAA) is a real entity or just radiographic artifact and whether it can be reliably measured. If it is intrinsic to the bone, it should not change with bone position. If it is clinically useful, it should be reproducible. Pre-operative and post-operative radiographs of 32 patients undergoing a proximal bony procedure of the first ray were evaluated independently by three foot and ankle specialists in order to determine the intra and inter-observer reliability of the distal metatarsal articular angle (DMAA). In addition, the hallux valgus angle (HVA), intermetatarsal angle (IMA) and joint congruency/subluxation were determined. We used ANOVA (Scheffe's F-test) to determine reliability of the angular measurements; a p value of less than 0.05 indicates poor reliability and a p value of greater than 0.05 indicates reliability. Intra-observer reliability was good for all angular measurements (HVA, IMA, DMAA pre-op, and DMAA postop) with p values ranging from 0.33 to 0.95. Inter-observer reliability of the HVA and IMA was good (p = 0.63 and p = 0.32). Inter-observer reliability of the pre-op DMAA approached statistically poor reliability (p = 0.09) and the post-op DMAA reliability was poor (p = 0.002). The DMAA reduced after the proximal procedure as measured by all observers, and averaged a reduction of 3.9°. Weighted kappa analysis also revealed that there was poor agreement in the determination of congruency and subluxation (Kappa statistic ranged from 0.07 to 0.19). This study suggests that there may be limited value in the DMAA as a clinical measure as it varies with examiner and with the hallux valgus angle.

scholarly journals Expected bony contact

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0029
Author(s):  
Görkem Kıyak ◽  
Tanıl Esemenli
Keyword(s):  
Hallux Valgus ◽  
Metatarsal Head ◽  
Hallux Rigidus ◽  
Full Potential ◽  
Congenital Deformities ◽  
Chevron Osteotomy ◽  
Valgus Angle ◽  
Angular Measurements ◽  
The Difference ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Hallux Valgus has been traditionally quantitated by measuring Hallux Valgus Angle (HVA) and Intermetatarsal Angle (IMA). Classic treatment algorithms based on angular measurements limits the use of distal chevron osteotomy to cases with an IMA less than 15º, assuming possible correction is only 4-6º which is equivalent to 4 – 6 mm displacement. There are studies confirming that larger displacement distal osteotomies can be safely performed. Since distal metatarsal osteotomies provide a correction by shifting, we have created a new algorithm based on the expected bony contact and aim to use the full potential of the distal chevron osteotomy. The purpose of the present study is to investigate if this new concept is more reliable than the widely accepted angular measurements in hallux valgus surgery. Methods: Patients with symptomatic hallux valgus subdivided as mild, moderate and severe hallux valgus using traditional angular radiologic measurements. After excluding the mild cases we calculated the expected bony contact by measuring the width of metatarsal head, and the required amount of lateral shifting. We performed a modified chevron osteotomy with extended plantar limb for the cases if the expected bony contact is more than 20%. We excluded patients with congenital deformities of the foot, hallux rigidus, tarsometatarsal (TMT) instability previous first ray trauma or foot and ankle surgery, diagnosis of rheumatic, dysmetabolic, neurologic, infective or psychiatric pathologies. The 100-point AOFAS hallux-metatarso-phalangeal-interphalangeal scale was used to assess the clinical outcome. We also recorded per and postoperative complications like infection, hallux varus, recurrence, etc. Radiologic measurements recorded for statistical analysis. Results: There were 24 patients suitable for chevron osteotomy according to our classification. We also subdivided our patients as moderate (14) and severe hallux valgus (10) with traditional classification. Table shows the Radiographic results and AOFAS scores by groups Paired t-tests showed significant improvement comparing pre-op and post-op AOFAS scores, IMA, HVA and sesamoid position of moderate, severe and all patient subgroups. (p<0.001) Unpaired t-tests showed that the difference is not significant between moderate and severe subgroups when we compare post-op AOFAS scores, IMA, HVA and sesamoid position. (p>0.05) The difference between the expected bony contacts was not statistically significant in the moderate and severe subgroups. Conclusion: Modified chevron osteotomy performed well enough radiologically and from the perspective of patient satisfaction when used according to the new concept of “expected bony contact” criteria. Dividing patients into angular subgroups did not affect the results of modified chevron osteotomy. The amount of possible lateral translation is not correlated with IMA and HVA. Our study has shown that expected bony contact is a reliable criteria and superior to angular measurements for preoperative planning in hallux valgus surgery.

scholarly journals PO 18217 - Radiographic evaluation of results of percutaneous surgery of Hallux Valgus

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 48S
Author(s):  
Jorge Eduardo De Schoucair Jambeiro ◽  
Antero Tavares Cordeiro Neto ◽  
Fernando Delmonte Moreira ◽  
José Augusto de Oliveira ◽  
Marcela Arimatea Cabral
Keyword(s):  
Hallux Valgus ◽  
Postoperative Period ◽  
Radiographic Evaluation ◽  
Percutaneous Surgery ◽  
Average Value ◽  
Percutaneous Procedures ◽  
Chevron Osteotomy ◽  
Valgus Angle ◽  
Angular Measurements ◽  
Deviation Measurement

Introduction: There is no consensus regarding the best surgical treatment for Hallux Valgus (HV). The use of percutaneous procedures for HV has been increasingly explored. The present study aims to evaluate and compare the radiographic results of percutaneous surgeries for HV treatment performed at our institution. Methods: A retrospective study was performed on radiographs and medical records of patients undergoing percutaneous surgery for HV treatment from August 2017 to August 2018. Using pre and postoperative radiographs, the Hallux valgus angle (HVA), intermetatarsal angle (IMA), and bone sesamoid deviation measurement and classification were performed according to the AOFAS criteria for angular measurements. Results: We evaluated the radiographs of 19 patients, representing a total of 25 feet, with a minimum segment time of four months, 84.2% females, and a mean age of 58 years. In 13 feet, there was an association of the Chevron and Akin techniques and in 12 of the Reverdin-Isham and Akin techniques. On average, the preoperative IMA was 13.4º, and in the postoperative period, 7.2º HVA had a mean of 26.3º in the preoperative period and in the postoperative period an average value of 11,2º. We observed improvement of the dislocation of the sesamoids in all cases by postoperative radiography. We did not find any serious complications. Discussion: There was a decrease in the postoperative measurements in all evaluated cases, with a mean of 15º in the HVA and 6,2º in the IMA. Chevron osteotomy associated with AKIN obtained a higher degree of correction of the IMA as predicted. The HVA using both techniques provided good correction without significant differences, which could be explained by the association of the Akin osteotomy in the two evaluated techniques.  Conclusion: Percutaneous surgeries with Chevron plus Akin and Riverdin-Isham plus Akin techniques performed at our institution proved to be efficient for HV correction, with a reduction of postoperative HVA and IMA.

scholarly journals The Metatarsal Axis Deviation Angle: A Novel Angular Measurement for Planning Surgery of Severe Hallux Valgus

2017 ◽  
Vol 4 (2) ◽  
pp. 97-99
Author(s):  
Avadhoot P Kantak
Keyword(s):  
Hallux Valgus ◽  
Angular Measurement ◽  
Asia Pacific ◽  
Axis Deviation ◽  
Deviation Angle ◽  
First Metatarsal ◽  
Complex Procedure ◽  
Angular Measurements ◽  
Metatarsus Adductus ◽  
Severe Hallux Valgus

ABSTRACT Surgical planning for hallux valgus is a complex procedure. Many angular measurements are described to decide on the correct procedure. Primus metatarsus varus is considered as one of the important factors in the causation and persistence of hallux valgus. Intermetatarsal angle (IMA) has been used to assess the first metatarsal varus. However, we identified a normal IMA in some feet with severe hallux valgus; and these feet had metatarsus adductus. Hence, after further investigations, we propose a new angular measurement to detect axis deviation of the first metatarsal. We have called this the metatarsal axis deviation angle (MADA). We also recommend a basal realignment osteotomy in hallux valgus with the MADA of more than 30°. How to cite this article Kantak AP. The Metatarsal Axis Deviation Angle: A Novel Angular Measurement for Planning Surgery of Severe Hallux Valgus. J Foot Ankle Surg (Asia-Pacific) 2017;4(2):97-99.

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