Geometric Data of Hallux Valgus Feet

The aim of this study is to find basic quantitative geometric data that may contribute to the understanding of the etiology of hallux valgus. Embalmed specimens with existing hallux valgus (N = 39) were dissected; 28 variables were measured with a Vernier caliper gauge and toe goniometer. Correlations between pairs of independent variables were calculated. Linear dependency of the hallux angle, varus angle, and the width of the forefoot on a number of independent variables was analyzed by multiple linear regression. A least squares method and a stepwise procedure were used. The distance from the tendon of the flexor hallucis longus muscle to the head of the first metatarsal bone explains more than other variables the variation in hallux angle and width of the forefoot. A widened forefoot is significantly correlated with both hallux and varus angles. The interrelation of the predictor parameters illustrates the complicated hallux valgus phenomenon.

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Three-Dimensional Analysis of the First Metatarsal Bone in Minimally Invasive Distal Linear Metatarsal Osteotomy for Hallux Valgus

Foot & Ankle International ◽

10.1177/1071100719875222 ◽

2019 ◽

Vol 41 (1) ◽

pp. 84-93 ◽

Cited By ~ 1

Author(s):

Hiroyuki Seki ◽

Satoshi Oki ◽

Yasunori Suda ◽

Kenichiro Takeshima ◽

Tetsuro Kokubo ◽

...

Keyword(s):

Minimally Invasive ◽

Hallux Valgus ◽

Morphological Changes ◽

Case Series ◽

Metatarsal Bone ◽

Ct Scans ◽

Metatarsal Osteotomy ◽

Level Of Evidence ◽

3 Dimensional ◽

First Metatarsal

Background: Modified Bösch osteotomy (distal linear metatarsal osteotomy [DLMO]) is one of the minimally invasive correctional surgeries for hallux valgus. The 3-dimensional correctional angles and distances of the first metatarsal bone in DLMO have not been clarified. The purpose of this study was to analyze the 3-dimensional postoperative morphological changes of the first metatarsal bone in DLMO. Methods: Twenty patients (30 feet) who underwent DLMO were enrolled. Preoperative plain radiographs and computed tomography (CT) scans of the feet were examined. Postoperative radiographs and CT scans were also obtained after bone union. The surface data of the pre- and postoperative first metatarsals were reconstructed from the CT data. The positions of the distal ends of the first metatarsals described with respect to the proximal ends were calculated using CT surface-matching technique. Results: The distal end of the first metatarsal after DLMO was significantly supinated (10.2 ± 6.0 degrees, P < .001), adducted (6.0 ± 11.8 degrees, P = .004), dorsiflexed (11.1 ± 10.9, P < .001), shortened (7.4 ± 2.5 mm, P < .001), elevated (2.3 ± 3.1 mm, P = .001), and laterally shifted (8.2 ± 3.0 mm, P < .001) compared to the preoperative metatarsal distal end. Supination correction demonstrated a significant correlation with adduction correction ( r = 0.659, P < .001) on correlation analyses between these parameters. Conclusion: The 3-dimensional corrections of the first metatarsal bone after DLMO were evaluated. Pronation and abduction were successfully corrected. Furthermore, adduction correction might be an important factor affecting correction of pronation. Level of Evidence: Level IV, retrospective case series.

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Vascular anatomy of the first metatarsal bone and surgical implications according to the severity of hallux valgus deformity: A cadaveric study

Foot and Ankle Surgery ◽

10.1016/j.fas.2020.07.012 ◽

2020 ◽

Author(s):

Sérgio Soares ◽

Tiago Mota Gomes ◽

Gustavo Campos ◽

Filipe Medeiros ◽

João Bragança ◽

...

Keyword(s):

Hallux Valgus ◽

Vascular Anatomy ◽

Valgus Deformity ◽

Metatarsal Bone ◽

Cadaveric Study ◽

First Metatarsal ◽

Hallux Valgus Deformity

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PO 18235 - New tomographic method for measuring metatarsal rotation in hallux valgus

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2019.v13.1047 ◽

2019 ◽

Vol 13 (Supl 1) ◽

pp. 52S

Author(s):

Bruno Rodrigues de Miranda ◽

Rui Dos Santos Barroco ◽

Leticia Zaccaria Prates de Oliveira ◽

Mahmoud Beerens Abdul Ghani Abdul Ghani ◽

Antonio Candido de Paula Neto ◽

...

Keyword(s):

Computed Tomography ◽

Hallux Valgus ◽

Weight Bearing ◽

Alpha Angle ◽

Metatarsal Bone ◽

3 Dimensional ◽

First Metatarsal ◽

Computed Tomography Scans ◽

Tomographic Method ◽

The Relationship

Introduction: Hallux valgus is a 3-dimensional deformity involving an increased intermetatarsal I/II angle and a rotational deformity of the first metatarsal bone. Kim et al. developed a method for measuring the tibial sesamoid position relative to the coronal rotation of the first metatarsal bone in computed tomography scans under simulated weight-bearing conditions. Objective: To describe a method for the topographic assessment of the correction of tibial sesamoid and metatarsal pronation using computed tomography scans under simulated weight-bearing and active toe extension. Method: We performed computed tomography under simulated weight-bearing conditions with and without active toe dorsiflexion, observing the degree of metatarsal pronation and sesamoid subluxation. For measurement purposes, we used the classifications of Kim et al. and Smith et al. Results: We observed tomographic correction, both angular and rotational, by measuring the intermetatarsal angle and tibial sesamoid position, which were confirmed by the change in the alpha angle suggested by Kim et al. Discussion: Toe extension was described as a peroneus longus tendon activation test by Klemola et al., who used this maneuver to demonstrate clinical rotational correction of hallux valgus. We described the use of a tomographic technique that followed this principle to preoperatively observe the underlying factors that may affect the rotational correction of the deformity. Conclusion: The method has the capacity for correction in various planes involving derotation of the first metatarsal bone and the relationship between such derotation and the change in sesamoid position in relation to the coronal plane of the foot.

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PO 18074 - Rotational biplanar Chevron osteotomy

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2019.v13.988 ◽

2019 ◽

Vol 13 (Supl 1) ◽

pp. 9S

Author(s):

Tiago Soares Baumfeld ◽

Marcelo Pires Prado ◽

Alberto Mendes ◽

Caio Augusto De Souza Nery ◽

Daniel Soares Baumfeld

Keyword(s):

Internal Rotation ◽

Hallux Valgus ◽

Valgus Deformity ◽

Metatarsal Bone ◽

Distal Fragment ◽

Rotational Deformity ◽

First Metatarsal ◽

Chevron Osteotomy ◽

Hallux Valgus Deformity ◽

Rotation Component

Introduction: The Chevron osteotomy is a reliable and popular osteotomy for treating hallux valgus worldwide. Many modifications have been described, but none of them address the rotational deformity of the first metatarsal. The objective of this study is to describe a variation of biplanar Chevron osteotomy that can address first metatarsal rotation when necessary. Methods: The indications for the Rotational Biplanar Chevron Osteotomy (RBCO) are mild to moderate hallux valgus deformity associated with hallux pronation related to internal rotation of the first metatarsal bone. We describe a technique that uses a medial-based wedge parallel to the plantar limb of the osteotomy to free the distal fragment for correct rotation. Results: The more recent concern about hallux valgus surgery represents a very interesting concept that this deformity truly occurs in three different planes, and we may have mistreated the rotation component using current techniques. Many authors have revisited numerous common techniques to adapt them to correct metatarsal pronation. To the best of our knowledge, this is the first paper to describe a modification of the Chevron osteotomy to address rotation of the first metatarsal. Conclusion: We can conclude that rotational biplanar Chevron osteotomy is an useful tool in the treatment of mild hallux valgus associated with metatarsal pronation.

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Results of Hallux Abducto Valgus Surgical Correction Using Two 1.1mm Mini TightRope Constructs

Revista de Chimie ◽

10.37358/rc.20.2.7891 ◽

2020 ◽

Vol 71 (2) ◽

pp. 52-57

Author(s):

Mihai Nica ◽

Corina Panaitescu ◽

Bogdan Cretu ◽

Panti Zsombor ◽

Camelia Tecu ◽

...

Keyword(s):

Hallux Valgus ◽

Treatment Option ◽

Functional Impairment ◽

Metatarsal Bone ◽

Foot Deformity ◽

Moderate Severity ◽

First Metatarsal ◽

First Ray ◽

The Mean ◽

Correction Potential

Hallux valgus represents an acquired foot deformity defined by medial deviation of the first metatarsal bone combined with lateral shift of the hallux and medial metatarsophalageal joint eminence enlargement. The functional impairment and metatarsalgia generated stem from the biomechanical imbalance which does not allow for normal transfer of weight trough the first ray during walking. The results generated with our experience with the 1.1mm Mini TightRope� Disposable Kitin the treatment of hallux valgus are analyzed in this paper. A total number of 24 feet (12 bilateral cases) with hallux valgus, surgically treated in our department were followed for a period of minimum twelve months and evaluated. The results showed an improvement of the mean preoperative IMA 14.6�to 7.9� postoperatively and 9.2� at six months after surgery. The preoperative measured HVA was reduced from 28.4to 14.2� at once and 16.1� after six months. The AOFAS hallux metatarsophalangeal-interphalangeal score resulted improvement reflects the functional benefits. These results confirm the good correction potential of the technique and support it as avalid treatment option for mild to moderate severity hallux valgus.

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