scholarly journals Intra-articular fracture of proximal phalanx of great toe accompanied by valgus deformity associated with sports activities

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901769032
Author(s):  
Sungsoo Kim ◽  
Myoungjin Lee ◽  
Sangyun Seok
Keyword(s):  
Hallux Valgus ◽  
Proximal Phalanx ◽  
Valgus Deformity ◽  
Lateral Side ◽  
Great Toe ◽  
Fracture Group ◽  
Articular Fracture ◽  
Medial Side ◽  
Hallux Valgus Interphalangeus ◽  
Sports Activities

Background: We analyzed clinical and radiologic examination of intra-articular fracture of the proximal phalanx of great toe accompanied by valgus deformity associated with sports activities. Therefore, we assessed valgus deformity of great toe at fracture side and contralateral side by simple radiograph in order to confirm the causal relation of fracture and deformity. Methods: A retrospective study was conducted on 23 cases, between January 2000 and August 2014, which showed an intra-articular fracture of proximal phalanx which was diagnosed after visiting our hospital for valgus deformity of great toe as a chief complaint. All patients were involved in sports activities for over 2 years. The site of fracture was the lateral side of the proximal phalanx head in 16 cases and the medial side of the proximal phalanx base in 7 cases. In order to assess the valgus deformity of great toe, hallux valgus angle (HVA) and hallux valgus interphalangeal angle (HVIPA) were measured on the weight-bearing foot radiograph. Results: The average HVA of the fracture group on the lateral side of the proximal phalanx head was 10.5° and HVIPA was 17.8°, while the average HVA of the fracture group on the medial side of the proximal phalanx base was 18.1° and HVIPA was 10.7°. Among the 16 cases with a fracture on the lateral side of the head, 13 cases showed hallux valgus interphalangeus (81.3%), while all 7 cases of fracture on the medial side of the base showed hallux valgus (100%). Conclusion: Hallux valgus was mostly found on the fracture of the medial side of the proximal phalanx base, while hallux valgus interphalangeus was mostly found on the fracture of the lateral side of the proximal phalanx head.

Surgical Treatment of Patients with Painful Instability of the Second Metatarsophalangeal Joint

1998 ◽  
Vol 19 (3) ◽  
pp. 137-143 ◽  
Author(s):  
Andre Gazdag ◽  
Andrea Cracchiolo
Keyword(s):  
Hallux Valgus ◽  
Stress Test ◽  
Excellent Result ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Joint Stability ◽  
Hallux Valgus Deformity ◽  
Flexor Digitorum ◽  
Second Toe

An unstable second metatarsophalangeal joint may produce pain in the forefoot. Eighteen patients (20 feet) had a transfer of the flexor digitorum longus to the extensor side of the base of the proximal phalanx performed as the primary procedure to stabilize this painful joint. Most patients had a hallux valgus deformity that also required correction, because it either was also symptomatic or was preventing adequate reduction of the second toe. A ruptured plantar plate of the second metatarsophalangeal joint was demonstrated in 13 feet and in these joints appeared to be the cause of the vertical instability. However, all feet showed an unstable joint upon clinical examination. A vertical-stress test almost always reproduced the patient's pain while demonstrating instability in the joint; this was the most prominent physical finding in these patients. Eleven patients (13 feet) had an excellent result. Seven patients (seven feet) had a fair result, but they complained only of mild and occasional pain at the joint on exertion. Although difficult to quantify, it appears that postoperative stiffness in the joint provided some of the joint stability seen in our patients. The flexor tendon transfer appears to be a satisfactory method to treating the unstable metatarsophalangeal joint and of relieving patients' pain, but may not, however, restore a normal alignment of the second toe. Correction of other forefoot deformities as hallux valgus and hammertoes may also be important in restoring metatarsophalangeal stability.

scholarly journals Effect of Physiotherapy on Foot Function During Treatment of Hallux Valgus

2019 ◽  
Vol 1 (12) ◽  
Author(s):  
Asta Samienė ◽  
Vaida Berneckė ◽  
Aurelija Simavičienė
Keyword(s):  
Physical Therapy ◽  
Muscle Strength ◽  
Hallux Valgus ◽  
Load Distribution ◽  
Valgus Deformity ◽  
Center Of Gravity ◽  
Public Institution ◽  
Great Toe ◽  
Hallux Valgus Deformity ◽  
Foot Function

Research background. The present final paper presents an analysis of the effects of physiotherapy on foot function when treating the hallux valgus deformity. The research object was the change of the deformity degree of the great toe, foot pain, muscle strength, load distribution in the sole, trajectory of the sole’s center of gravity and foot’s contact with the movement’s surface in different stages of walking after the treatment. Objectives of the research were to analyze scientific literature about the hallux valgus, the concept of foot function and its treatment; determine the changes in the deformity degree of the great toe, pain intensity and muscle strength prior to and after the physical therapy exercises; assess the load distribution in the soles of the respondents, trajectory of the sole’s center of gravity and foot’s contact with the movement’s surface in different stages of walking prior to and after the physiotherapy exercises. Methods. The study was carried out at the Out-Patient Recuperation Center of the Public Institution Šiauliai National Hospital. The computer-aided pedobarographic assessment of the foot was performed by a representative of the Bauerfeind Company at the Manual Medicine Clinic. The study was carried out from December 2013 to April 2014. Twelve respondents afflicted with hallux valgus deformity participated in the study. The duration of the exercise sessions was 11 Results. According to the analysis of the research data, the intensity of pain was influenced by both the exercises and the use of orthopedic supports. However, the pain decreased more after physiotherapy compared to the use of orthopedic supports. The changes in the deformity degree of the great toe and muscle strength were also positively affected by exercises. In EKt group the muscle strength of the tested muscles changed by 1–2 points. In the EO group the muscle strength and the deformity degree of the great toe remained unchanged after the use of orthopedic supports. Following the analysis of the load distribution in the sole, trajectory of the sole’s center of gravity and foot’s contact with the movement’s surface, it became obvious that the physiotherapy had positive a impact on the decrease of load distribution points in different places of the sole and the trajectory of the sole’s center of gravity for the respondents in the Conclusion. After the exercises the toe of one patient was aligned properly and the remaining patients were close to achieving proper alignment. Also, the exercises had a positive influence on the foot’s contact with the movement’s surface. The EO group did not observe any positive changes after using the orthopedic supports, i.e. the load distribution points, trajectory of the center of gravity and foot’s contact with the movement’s surface were not altered.Keywords: hallux valgus, foot function, physical therapy.

scholarly journals Bunion foot

2012 ◽  
Vol 140 (7-8) ◽  
pp. 533-536
Author(s):  
Zoran Vukasinovic ◽  
Nadan Mikic
Keyword(s):  
Decision Making ◽  
Hallux Valgus ◽  
Progressive Disease ◽  
Standing Position ◽  
Valgus Deformity ◽  
Great Toe ◽  
X Ray ◽  
Hallux Valgus Deformity ◽  
Chronic Progressive Disease ◽  
Single Method

Hallux valgus deformity is a complex chronic progressive disease primarily characterized by a lateral great toe deviation and deformity of the first metatarsophalageal joint. Numerous etiological factors are related with the expression of this disease, and they are divided into two categories: endogenous and exogenous. Complexity of the hallux valgus deformity is reflected with the progression of the disease that gives rise to numerous forefoot deformities. The diagnosis is first of all affirmed by clinical examination and x-ray of the feet in a standing position. Treatment could be either operative or conservative. Conservative treatment has shown to be totally unsuccessful. Before decision making on the type of operative treatment, the patient?s complaints, age, profession, clinical and x-ray findings must be taken into consideration. Until now, over two hundred different operative procedures have been described, which clearly supports the observation that there is no single method which could resolve all clinical varieties of this deformity. Therefore, today, when making a choice on the surgical procedure of hallux valgus deformity, the utilization of surgical algorithm is recommended.

scholarly journals The corrective ability of the double chevron and Akin osteotomies on medial sesamoid position in Hallux Valgus deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Jie Chen ◽  
Eugene Stautberg ◽  
David Spak ◽  
Gregory Schneider ◽  
Vinod Panchbhavi
Keyword(s):  
Hallux Valgus ◽  
Recurrence Rate ◽  
Lateral Displacement ◽  
Weight Bearing ◽  
Valgus Deformity ◽  
Observer Agreement ◽  
P Value ◽  
Great Toe ◽  
Hallux Valgus Deformity ◽  
Akin Osteotomy

Category: Bunion Introduction/Purpose: Recurrence of hallux valgus deformity is a common post-operative complication with rates in the literature ranging from 2.7 – 30%. Lateral displacement of the great toe medial sesamoid is correlated with a high recurrence rate, and failure to reduce sesamoid position has been implicated as a risk factor for recurrence due to an uncorrected deforming force. Sesamoid position has been studied in relation with Scarf osteotomy, but not other corrective osteotomies. The goal of this study is to determine the efficacy of the double chevron and Akin osteotomy in reducing the great toe medial sesamoid. Methods: We retrospectively reviewed all patients in the last five years undergoing hallux valgus correction via the double chevron and Akin osteotomy method with pre-operative and post-operative weight bearing radiographs. We measured sesamoid position pre and post-operatively using the Hardy-Clapham (HC) scale of I-VII with V or greater representing a laterally displaced medial sesamoid. We also measured hallux valgus and inter-metatarsal angles. Measurements were made by three authors in orthopedics and one in radiology. We used intra-class correlation coefficient (ICC) to determine inter-observer agreement and establish reliability. With adequate ICC, we could consider the lead author’s measurements as representative of the group. We examined the percent of hallux valgus cases with displaced sesamoids pre-operatively. Next, we determined how many of those cases did we reduce the sesamoids to grade IV or less. Finally, we performed subgroup analysis for pre-operative HC grades V, VI, and VII to determine correction percentage by severity. Results: There were 49 patients with 53 feet treated with the double chevron and Akin osteotomies for hallux valgus correction. Of these, 39 (73.6%) had significant preoperative lateral displacement of the medial sesamoid characterized by HC grade of V or greater. We corrected 30/39 (77.0%) to a reduced position of HC grade IV or less (p-value 0.048). In sub-analysis, we achieved reduction of the medial sesamoid position in 14/14 feet (100%) with HC grade V, 6/9 feet (66.7%) with HC grade VI, and 10/16 feet (62.5%) with HC grade VII (p-value 0.037). The ICC was 0.91 for pre-operative HC scores and 0.79 for post-operative HC scores. Average pre and post-operative HVA was 29.4° and 8.7°, respectively. Average pre and post-operative IMA was 13° and 5.2° respectively. Conclusion: Our study validates the double chevron and Akin osteotomies as effective in correcting sesamoid position. We achieved correction in 30/39 (77%) cases with initial sesamoid displacement. For mild cases of displacement with HC grade V, sesamoid correction was always achieved, and we were likely to achieve correction in the more severe cases of sesamoid displacement with HC grade VI or VII as well. The technique is also effective at reducing HVA and IMA. We had acceptable inter- observer agreement which supports the reliability of our methods. Future studies should examine recurrence rate following the double chevron and Akin osteotomies prospectively.

Hallux Varus Interphalangeus Following Osteochondral Fracture of the Proximal Phalanx: A Case Report

2020 ◽  
Vol 110 (5) ◽  
Author(s):  
Calvin J. Rushing ◽  
Tarak Amin ◽  
Alberto Herrada ◽  
Steven M. Spinner
Keyword(s):  
Case Report ◽  
Hallux Valgus ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
First Metatarsophalangeal Joint ◽  
Osteochondral Fracture ◽  
Medial Head ◽  
Hallux Varus ◽  
Hallux Valgus Interphalangeus ◽  
Joint Fusion

Hallux valgus interphalangeus deformity has been previously reported in the literature following trauma and first metatarsophalangeal joint fusion. However, to the best of our knowledge, hallux varus interphalangeus deformity has not been previously reported. We present the case of a 26-year-old skeletally mature woman who sustained an acute, open hallux varus interphalangeus injury following an osteochondral fracture of the medial head of the proximal phalanx.

Treatment of Hallux Valgus by Oblique Osteotomy of the First Metatarsal

Foot & Ankle ◽  
1992 ◽  
Vol 13 (8) ◽  
pp. 447-452 ◽  
Author(s):  
Kosaku Mizuno ◽  
Masataka Hashimura ◽  
Mayako Kimura ◽  
Kazushi Hirohata
Keyword(s):  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
X Rays ◽  
Great Toe ◽  
First Metatarsal ◽  
Oblique Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle

This paper describes a simple technique of oblique osteotomy of the first metatarsal for treatment of symptomatic hallux valgus deformity. The osteotomy is performed at a 30° angle from the long axis of the metatarsal shaft. The head of the metatarsal is then displaced laterally to provide correction of the hallux valgus. This is an uncomplicated procedure for the treatment of hallux valgus. From 1984 through 1989, 53 feet in 31 patients were treated with an oblique osteotomy of the first metatarsal. A total of 49 feet in 27 patients were followed up more than 2 years. The follow-up x-rays and clinical examinations revealed a good result in 43 feet. In six feet of three patients, all of whom had simultaneous oblique osteotomies of both the first and second metatarsals, a fair or poor result was obtained. It was learned that oblique osteotomy for hallux valgus greater than 40° provided insufficient correction of the valgus angle or limitation of motion at the metatarsophalangeal joint of the great toe.

Influence of first proximal phalanx geometry on hallux valgus deformity: a finite element analysis

2015 ◽  
Vol 53 (7) ◽  
pp. 645-653 ◽  
Author(s):  
Enrique Morales-Orcajo ◽  
Javier Bayod ◽  
Ricardo Becerro-de-Bengoa-Vallejo ◽  
Marta Losa-Iglesias ◽  
Manuel Doblare
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Hallux Valgus ◽  
Proximal Phalanx ◽  
Valgus Deformity ◽  
Element Analysis ◽  
Hallux Valgus Deformity
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