Hallux-valgus-Chirurgie: begleitender Pes planus ohne Einfluss auf postoperatives Ergebnis

2021 ◽  
Vol 159 (06) ◽  
pp. 597-598
Keyword(s):  
Hallux Valgus ◽  
Pes Planus

Juvenile Hallux Valgus: Etiology and Treatment

1995 ◽  
Vol 16 (11) ◽  
pp. 682-697 ◽  
Author(s):  
Michael J. Coughlin
Keyword(s):  
Hallux Valgus ◽  
Normal Population ◽  
Surgical Correction ◽  
Metatarsal Osteotomy ◽  
Hallux Valgus Angle ◽  
Pes Planus ◽  
First Metatarsal ◽  
Chevron Osteotomy ◽  
Valgus Angle ◽  
Metatarsus Adductus

In an 11-year retrospective study of 45 patients (60 feet) with juvenile hallux valgus, a multiprocedural approach was used to surgically correct the deformity. A Chevron osteotomy or McBride procedure was used for mild deformities, a distal soft tissue procedure with proximal first metatarsal osteotomy was used for moderate and severe deformities with MTP subluxation, and a double osteotomy (extra-articular correction) was used for moderate and severe deformities with an increased distal metatarsal articular angle (DMAA). The average hallux valgus correction was 17.2° and the average correction of the 1–2 intermetatarsal angle was 5.3°. Good and excellent results were obtained in 92% of cases using a multiprocedural approach. Eighty-eight percent of patients were female and 40% of deformities occurred at age 10 or younger. Early onset was characterized by increased deformity and an increased DMAA. Maternal transmission was noted in 72% of patients. An increased distal metatarsal articular angle was noted in 48% of cases. With subluxation of the first MTP joint, the average DMAA was 7.9°. With a congruent joint, the average DMAA was 15.3°. In patients where hallux valgus occurred at age 10 or younger, the DMAA was increased. First metatarsal length was compared with second metatarsal length. While the incidence of a long first metatarsal was similar to that in the normal population (30%), the DMAA was 15.8° for a long first metatarsal and 6.0° for a short first metatarsal. An increased DMAA may be the defining characteristic of juvenile hallux valgus. The success of surgical correction of a juvenile hallux valgus deformity is intimately associated with the magnitude of the DMAA. Moderate and severe pes planus occurred in 17% of cases, which was no different than the incidence in the normal population. No recurrences occurred in the presence of pes planus. Pes planus was not thought to have an affect on occurrence or recurrence of deformity. Moderate and severe metatarsus adductus was noted in 22% of cases, a rate much higher than that in the normal population. The presence of metatarsus adductus did not affect the preoperative hallux valgus angle or the average surgical correction of the hallux valgus angle. Constricting footwear was noted by only 24% of patients as playing a role in the development of juvenile hallux valgus. There were six recurrences of the deformities and eight complications (six cases of postoperative hallux varus, one case of wire breakage, and one case of undercorrection).

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.

Pes Planus Deformity and Its Association With Hallux Valgus Recurrence Following Scarf Osteotomy

2020 ◽  
Vol 41 (10) ◽  
pp. 1212-1218
Author(s):  
Gavin John Heyes ◽  
Amir R. Vosoughi ◽  
Lizzy Weigelt ◽  
Lyndon Mason ◽  
Andrew Molloy
Keyword(s):  
Hallux Valgus ◽  
P Value ◽  
Level Of Evidence ◽  
Pes Planus ◽  
First Metatarsal ◽  
Scarf Osteotomy ◽  
Metatarsal Angle ◽  
Valgus Angle ◽  
Akin Osteotomy

Background: Hallux valgus recurrence is an unsatisfactory complication, with many causes postulated. This study investigated the effect of pes planus on recurrence after scarf osteotomy. Methods: A total of 183 feet were retrospectively reviewed. All patients were treated with a scarf osteotomy and if required Akin osteotomy. We measured preoperative lateral talus first metatarsal angle (T1MA) to study pes planus; an angle of under −4 degrees was considered pes planus. We measured pre and postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), and sesamoid location. In total 164 feet were suitable for inclusion, with follow-up of at least 6 months (10 males and 154 females, mean age: 52 years). Results: Recurrence frequency (HVA greater than 15 degrees) was 27 feet (16%). Hallux valgus recurrence was not influenced by gender ( P value = .66) or preoperative IMA ( P value = .48). Preoperative HVA greater than 35 degrees was associated with increased frequency of recurrence ( P value = .004). Those with T1MA less than −10 degrees demonstrated progression in HVA and deterioration in sesamoid location up to 6 months postoperatively ( P value = .038). HVA did not progress beyond 6 months. The prevalence of recurrent hallux valgus with normal T1MA was 1%, in T1MA −4 to −10 degrees it was 29% and in T1MA less than −10 degrees it was 47% ( P value <.001). Breaks in T1MA less than −4 degrees were found at the naviculocuneiform joint in 68% of feet in this series. Conclusion: The prevalence of hallux valgus recurrence correlated with the severity of pes planus. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Does the Presence of Pes Planus Deformity Increase Recurrence of Hallux Valgus Deformity Following Surgery?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0021
Author(s):  
Gavin Heyes ◽  
Eric Swanton ◽  
Lyndon Mason ◽  
Andrew P. Molloy
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Valgus Deformity ◽  
P Value ◽  
X Rays ◽  
Recurrence Rates ◽  
Pes Planus ◽  
Hallux Valgus Deformity ◽  
Increased Risk

Category: Bunion Introduction/Purpose: Factors linked with increased risk of developing Hallux Valgus include; shod footwear, genetic factors, metatarsal morphology, ligamentous laxity and Pes Planus. With regards to Pes planus, it has been suggested that the loss of the medial longitudinal arch in Pes Planus increases Hallux plantar medial pressures and drives deformity during heel rise. There is little in the literature regarding whether Pes Planus is associated with increased recurrence rates. Given this is a potentially modifiable risk factor we believe the risk of recurrence should be studied. This paper reports the results of a retrospective study following up 183 consecutive Hallux valgus cases. The primary objective is to evaluate whether pes planus is associated with increased recurrence following treatment. Methods: Retrospective review of consecutively treated patients from 07/03/2008 to 05/12/2017. Patients were typically followed up for six to twelve months depending on any additional factors that require follow up. X-rays were performed routinely at six weeks, three months and many had x-rays at six and/or 12 months for additional pathology. We examined radiological markers including Sesamoid location (using the Hardy and Clapham Classification), Hallux Valgus Angle (HVA), Intermetatarsal Angle, Meary’s angle and Talonavicular uncovering. 183 cases were reviewed, 12 were excluded due to previously amputated second toes, Hallux Varus, revision surgery and only 6 weeks follow up. This left 171 cases of which 75 had Pes Planus (Meary’s angle < -4°). Results: Table 1 describes the preoperative HVAs we encountered and the correction achieved along with frequencies. Postoperative measurements were taken off weight bearing x-rays. The incidence of recurrent HVA > 15° was significantly higher in those with Meary’s angle < - 4° (Chi-Sq 22.6 P-value 0.000002). Those with a Meary’s angle -20° to -10° had a significantly higher rate of recurrence than ones measuring -10° to -4° (Chi-Sq 9.7 P-value 0.0018 There was no difference in progression of recurrent deformity between those initially corrected to HVA < 15° (Chi-Sq 0.26 P- value 0.61) and those not. Multiple regression analysis revealed there was no meaningful association with sesamoid location or pes planus with recurrence of Hallux Valgus deformity. Conclusion: Our results demonstrate a link between Preoperative Pes Planus deformity and increased recurrence rates of Hallux Valgus deformity following surgery. Consideration of correction of pes planus and appropriate consent of recurrence rates should therefore be undertaken in treatment of hallux valgus in the presence of pes planus

Relationship Between Hallux Valgus and Pes Planus: Real or Fiction?

2020 ◽  
Vol 59 (3) ◽  
pp. 513-517
Author(s):  
Zafer Atbaşı ◽  
Yusuf Erdem ◽  
Ozkan Kose ◽  
Bahtiyar Demiralp ◽  
Serkan Ilkbahar ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Pes Planus

Relationship between Hallux Valgus and Pes Planus in Adult Patients

2020 ◽  
Author(s):  
Dong Hun Suh ◽  
Hak Jun Kim ◽  
Jung Ho Park ◽  
Young Hwan Park ◽  
Bong Mo Koo ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Adult Patients ◽  
Pes Planus

The Significance of Pes Planus in Juvenile Hallux Valgus

Foot & Ankle ◽  
1992 ◽  
Vol 13 (2) ◽  
pp. 53-56 ◽  
Author(s):  
Timothy E. Kilmartin ◽  
W. Angus Wallace
Keyword(s):  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Pes Planus ◽  
First Metatarsophalangeal Joint ◽  
Joint Deformity ◽  
Hallux Valgus Deformity ◽  
Significant Difference ◽  
Footprint Area ◽  
Arch Index

Pes planus of the foot is believed to be an important etiological factor in hallux valgus. This study compares the degree of pes planus in normal and hallux valgus feet. The arch index, or ratio of the area of the middle third of the foot to the total footprint area, was calculated on 128 footprints. An unpaired t-test determined no significant difference between the arch index of 32 11-year-old children with hallux valgus and 11-year-olds with no first metatarsophalangeal joint deformity ( P >.05). The height of the arch is not relevant to the hallux valgus deformity. Arch supports designed to raise the height of the arch can play only a palliative role in the management of the condition.

scholarly journals Pronation of the First Metatarsal in Hallux Valgus Deformity

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0019 ◽  
Author(s):  
Chris Cychosz ◽  
Alyssa Johnson ◽  
Phinit Phisitkul
Keyword(s):  
Hallux Valgus ◽  
Structural Parameters ◽  
Alpha Angle ◽  
Valgus Deformity ◽  
Control Group ◽  
Pes Planus ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
Number Of Patients ◽  
Weightbearing Ct

Category: Bunion Introduction/Purpose: Hallux Valgus is a common condition often resulting in chronic pain and disability. However, the precise etiology of Hallux Valgus deformity remains poorly understood and likely results from a combination of intrinsic and extrinsic factors. There is conflicting evidence regarding as to whether hallux valgus deformity is associated with increased pronation of the first metatarsal. The purpose of this study was to investigate the correlation between hallux valgus and pronation of the first metatarsal in relation to other structural parameters of the foot. Methods: Eighty-five consecutive patients with clinically and radiographically diagnosed hallux valgus, pes planus, or cavovarus that underwent imaging with weightbearing CT between January 2014 and May 2016 were retrospectively enrolled and compared to a control group consisting of patients who with scans completed for indications unrelated to hallux valgus (e.g. ankle arthritis) and were determined to have normal foot structure. Using a weightbearing CT axial view, the alpha angle of the first metatarsal was measured and correlated with other radiographic parameters on plain weightbearing radiographs including Meary’s angle, hallux valgus angle, intermetatarsal angle, and calcaneal pitch. Results: There were 39 males and 46 females (91 feet) with a mean age of 47.16 (SD14.89) years and BMI of 32.99 (SD 7.35) kg/m2 included in this study. Mean pronation of the first metatarsal significantly (p<0.001) different in all group compared to the control: 15.23 (SD 7.96) in the hallux valgus group, 15.22 (SD 8.56) in the pes planus group, negative 0.23 (SD 5.99) in the cavovarus group, and 6.98 (SD 5.09) in the control group. There was moderate correlation between meary’s angle, tripod index, calcaneal pitch, and the alpha angle (negative 0.70, 0.65, negative 0.53, respectively) with a p-value < 0.001. HVA demonstrated little correlation with the measured alpha angle (0.23), p<0.03. Conclusion: Patients with hallux valgus deformity demonstrated a significantly higher pronation of the first metatarsal compared to the control group. However, a greater number of patients in the hallux valgus group had flatfoot deformity and further analysis revealed a greater correlation between foot type and pronation of the first metatarsal. Weightbearing CT is a reasonable way to image complex forefoot deformities prior to bunion surgery and it is important to take into account rotation of the first metatarsal in bunion surgery.

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