scholarly journals New screening method for hallux valgus with using smartphone

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0024
Author(s):  
Shibuya Hayatoshi ◽  
Tomoyuki Nakasa ◽  
Mikiya Sawa ◽  
Yusuke Tsuyuguchi ◽  
Munekazu Kanemitsu ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Screening Method ◽  
Conventional Radiography ◽  
Standing Position ◽  
Mean Value ◽  
Hallux Valgus Angle ◽  
Valgus Angle ◽  
The Mean ◽  
Anterior Knee

Category: Midfoot/Forefoot Introduction/Purpose: We developed a new screening method for hallux valgus during weight bearing using the photo-capturing function in cell phones. Methods: We compared apparent hallux valgus angles measured from photographs of people in a standing position during weight bearing, which were captured on a smartphone (smartphone Hallux Valgus Angle: SP-HVA) (Smartphone Method), with hallux valgus angles determined using conventional radiography in a standing posture during weight-bearing (X-ray HVA: XR-HVA). We evaluated 37 feet of 25 patients (5 men and 25 women) who visited our hospital. The mean age at the time of the visit was 73.9 years. In the Smartphone Method, subjects stood upright and the examiner used a smartphone to take photos of both feet from above while holding the phone at the level of the anterior knee. Results: The mean value was 36.2° for SP-HVA and 36.7° for XR-HVA; the two methods showed a statistically significant correlation (correlation coefficient of 0.86). Conclusion: Our smartphone-assisted screening method for hallux valgus was possible to make a diagnosis equivalent to conventional radiography method without radiation exposure.

scholarly journals Radiographic Recurrence of Hallux Valgus Based on Osteotomy Location

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0021
Author(s):  
Andrew Federer ◽  
Travis Dekker ◽  
David Tainter ◽  
Jordan Liles ◽  
Mark Easley ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Surgical Correction ◽  
P Value ◽  
Single Individual ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
Valgus Angle ◽  
Significant Difference

Category: Bunion Introduction/Purpose: Hallux valgus (HV) is one of the most common deformities of the foot resulting in pain and lifestyle modification of the patient. Recurrence rates of 10-47% have been documented in single individual osteotomy series. Unfortunately, surgical correction and recurrence are often defined as changes related to normal radiographs and not actually as the magnitude of correction lost with follow-up. Currently there have not been studies evaluating the percentage of recurrence of intermetatarsal angle (IMA) and hallux valgus angle (HVA). As there is substantial difference in starting IMA and HVA, as well as amount of surgical correction, our goal was to evaluate the percentage loss of correction over time comparing preoperative, initial postoperative and minimum of 2-year follow up radiographs among three different surgical correction techniques. Methods: This is a retrospective chart review study that examines the weight-bearing radiographic measurements of patients undergoing hallux valgus corrective surgery at a single institution over 5 years. Fifty-three patients were divided into first tarsometatarsal arthrodesis (i.e. Lapidus), mid-diaphyseal osteotomies (i.e. scarf), and distal metatarsal osteotomies (i.e. chevron). The preoperative, initial postoperative, and final follow up weight-bearing radiographs were measured for intermetatarsal angle (IMA) and hallux valgus angle (HVA). Primary outcome was percentage of recurrence of IMA and HVA, with the difference in angles between preoperative and initial postoperative weight-bearing films being considered 100% correction. The percentage of recurrence between initial postoperative and most recent follow up was then calculated (Figure 1A). A one-way analysis of variance (ANOVA) test and post-hoc Tukey-Kramer tests were used to compare preoperative IMA and HVA and percentage recurrence of IMA and HVA at most recent follow up. Results: There was no significant difference between Lapidus (14.3deg) and mid-diaphyseal osteotomies (12.7deg) in preoperative IMA (p-value=0.26). There was a significant difference between Lapidus (-0.3deg) and mid-diaphyseal (2.8deg) osteotomies for degree of hallux valgus recurrence as measured by IMA between initial postoperative films and final 2-year follow up (p-value=0.009). Lapidus procedure showed a greater magnitude decrease in IMA degrees from preoperation to final follow up compared to distal osteotomy (p-value=0.037) and trended toward significance compared to mid-diaphyseal (p-value=0.056). Mid-diaphyseal osteotomies (30%) showed a statistically significant higher percentage of IMA recurrence compared to Lapidus (-11%) (p-value=0.0014) (Figure 1B). When comparing percentage recurrence of HVA, distal osteotomies had a significantly smaller rate of recurrence when compared to the diaphyseal osteotomies (p-value=0.030). Conclusion: Though Lapidus and mid-diaphyseal osteotomies were performed for patients with a similar preoperative IMA, mid-diaphyseal osteotomies had a significantly higher percentage of recurrence at 2-year follow up compared to Lapidus procedures. Moreover, Lapidus procedures trended toward greater overall of IMA correction compared to mid-diaphyseal osteotomies. When either a Lapidus or mid-diaphyseal osteotomy is indicated, a Lapidus procedure may result in decreased rate of radiographic recurrence of hallux valgus at 2 years.

Excision Arthroplasty for Hallux Valgus in the Elderly: A Comparison between the Keller and Modified Mayo Operations

Foot & Ankle ◽  
1992 ◽  
Vol 13 (6) ◽  
pp. 317-320 ◽  
Author(s):  
Richard Stephen Majkowski ◽  
Simon Galloway
Keyword(s):  
Hallux Valgus ◽  
Elderly Population ◽  
The Elderly ◽  
Hallux Valgus Angle ◽  
The United Kingdom ◽  
Valgus Angle ◽  
Significant Correction ◽  
Good Pain Relief ◽  
The Mean ◽  
Excision Arthroplasty

A retrospective clinical and radiological review of 51 patients (mean age 66 years) was performed to assess the outcome of excision arthroplasty for hallux valgus in an elderly population and to compare the results of the Keller, which is still used frequently in many centers in the United Kingdom, and modified Mayo operations. Although significant correction of the deformity was obtained with both procedures, this was incomplete and the mean residual hallux valgus angle was greater than 20°. Lateral metatarsalgia was present in over 40% of patients. Both procedures provided good pain relief, and considerable narrowing of the forefoot was obtained with the modified Mayo operation. Excision arthroplasty in the elderly should be reserved for the low demand patient with symptomatic degenerative changes in the first MP joint in the absence of lateral metatarsalgia.

Radiographic Assessment of Foot Alignment in Juvenile Hallux Valgus and Its Relationship to Flatfoot

2019 ◽  
Vol 40 (9) ◽  
pp. 1079-1086
Author(s):  
Hyun Woo Kim ◽  
Kun Bo Park ◽  
Yoon Hae Kwak ◽  
Seokhwan Jin ◽  
Hoon Park
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Hallux Valgus Angle ◽  
Hindfoot Alignment ◽  
First Metatarsal ◽  
Metatarsal Angle ◽  
Valgus Angle ◽  
Significant Difference ◽  
Metatarsus Adductus ◽  
Foot Alignment

Background: The relationship between juvenile hallux valgus (JHV) and flatfoot has not been clearly established. The aim of this study was to assess radiographic measurements in feet with JHV compared with matched controls and to investigate whether the foot alignment of JHV is related to flatfoot. Methods: We retrospectively reviewed 163 patients with JHV as defined as hallux valgus angle greater than 20 degrees and intermetatarsal greater than angle than 10 degrees. Patients with open physes of the feet and who had weight-bearing radiographs of the feet were included. Another 55 normal participants served as controls. Patients with JHV were divided into 2 subgroups: Group 1 included patients with asymptomatic JHV and group 2 consisted of those treated with correctional surgery for painful JHV. Twelve radiographic indices were analyzed, including calcaneal pitch angle, tibiocalcaneal angle, talocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, lateral talo–first metatarsal angle, anteroposterior talo–first metatarsal angle, metatarsus adductus angle, hallux valgus angle, intermetatarsal angle, distal metatarsal articular angle, and first metatarsal cuneiform angle. The groups were compared by age, gender, and the above radiographic parameters. Results: There was no significant difference in hindfoot alignment of patients with JHV and controls. Naviculocuboid overlap ( P <.001), lateral talo–first metatarsal angle ( P = .002), and metatarsus adductus angle ( P = .004) were significantly greater in patients with JHV than in controls, whereas the anteroposterior talo–first metatarsal angle ( P = .026) was significantly less. Symptomatic and asymptomatic JHV patient subsets showed no significant radiologic differences. Conclusion: Radiographic profiles in patients with JHV were inconsistent with regard to features of flatfoot, and foot alignment was unrelated to the presence of symptoms or degree of deformity in JHV. Level of Evidence: Level III, retrospective comparative series.

Relationship of Dome Height of the First Metatarsal Head with Hallux Valgus Angle and Metatarsophalangeal Alignment

2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Esin Derin Cicek ◽  
Feyza Akan Begoglu ◽  
Ilknur Aktas ◽  
Feyza Unlu Ozkan
Keyword(s):  
Hallux Valgus ◽  
Articular Surface ◽  
Metatarsal Head ◽  
Standing Position ◽  
Dome Height ◽  
Hallux Valgus Angle ◽  
Radiographic Images ◽  
First Metatarsal ◽  
Valgus Angle ◽  
Study Results

Objectives Hallux valgus (HV) is a progressive foot deformity in which the first metatarsophalangeal (MTP) joint is affected. The relationship between the dome height of the first metatarsal head and the HV deformity has not been studied previously. This study aimed to investigate a possible relation of the dome height of the first metatarsal head with articular alignment and the hallux valgus angle (HVA), which is frequently used to evaluate HV. Methods A total of 129 feet of 68 patients were included in the study. Anteroposterior digital radiographic images of the foot taken in a weightbearing, standing position were used to assess the HVA, dome height, and shape of the first metatarsal head and the alignment of the MTP joint. The dome height of the first metatarsal head is the vertical distance from the base to the highest point of the articular surface doming. The alignment was categorized into three groups: aligned, deviated, and subluxated. Patients were assigned into three groups based on the HVA: Normal, Mild HV and Moderate HV. Results A statistically significant, positive correlation was found between the HVA and the dome height of the first metatarsal head (r = 0.293, P = 0.001 and P &lt; 0.05). The dome height was significantly lower in the patients with a normal HVA than those with a high HVA (P1 = 0.042, P2 = 0.039 and P &lt; 0.05, respectively). The dome height of the first metatarsal head was found significantly higher in feet with subluxation, compared to feet aligned and deviated (P1 = 0.001; P2 = 0.0089 and P &lt; 0.05, respectively). Conclusions Our study results suggest that HV deformity may be related to an increased dome height and the measurement of the dome height of the first metatarsal head might be used to evaluate an anatomic tendency toward HV development.

scholarly journals The interobserver reliability of first metatarsal rotational component of axial sesamoid radiographs in hallux valgus

2020 ◽  
Vol 14 (3) ◽  
pp. 249-253
Author(s):  
Mariel García-Limón ◽  
Jaime Ortiz-Garza ◽  
Abraham Espinosa-Uribe ◽  
Eduardo Carranza-Cantú ◽  
Javier Meza-Flores ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Bone Structure ◽  
Interobserver Reliability ◽  
Weight Bearing ◽  
Case Series ◽  
Rotational Component ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
First Metatarsal ◽  
Valgus Angle

Objective: Hallux valgus is a progressive triplanar deformity of the forefoot with an important rotational component (RC) in the first metatarsal, which has been associated with recurrence. There is controversy about using weight-bearing vs. non-weight-bearing radiographs in RC measurement. This study aims to assess interobserver reliability for RC of the first metatarsal using a non-weight-bearing sesamoid view, as well as to correlate the hallux valgus angle, intermetatarsal angle, distal metatarsal articular angle (DMAA) and sesamoid position regarding RC. Methods: An observational, cross-sectional and descriptive study was conducted with 81 feet from 48 patients (66.6% female). RC was evaluated regarding the first metatarsal proximal shaft in non-weight-bearing axial metatarsal radiographs and weight-bearing anteroposterior radiographs. Measurements were taken independently by two foot and ankle subspecialists and an orthopedic resident, all of whom were blinded. Results: Statistically significant intraclass correlations (p = 0.02) were obtained for first metatarsal RC assessment among the three observers (95%CI 0.01–0.65; Cronbach’s α =0.41) in non-weight-bearing axial metatarsal views. Significant correlations (Spearman ρ) were also found for hallux valgus angle (p = 0.04) and DMAA (p = 0.01), and non-significant correlations were found for intermetatarsal angle and sesamoid position (p > 0.05). Conclusion: The significant correlations between hallux valgus angle and DMAA for RC suggest that RC is isolated from the first metatarsal bone structure. This practical assessment method may isolate the first metatarsal head RC regarding the proximal metatarsal in the metaphyseal region and could be useful in centers where weight-bearing CT scans are not available. Level of Evidence IV; Therapeutic Studies; Case Series.

Comparison of Radiographic and Clinical Results After Extended Distal Chevron Osteotomy With Distal Soft Tissue Release With Moderate Versus Severe Hallux Valgus

2018 ◽  
Vol 40 (3) ◽  
pp. 297-306 ◽  
Author(s):  
Jae Hwang Song ◽  
Chan Kang ◽  
Deuk Soo Hwang ◽  
Gi Soo Lee ◽  
Sang Bum Lee
Keyword(s):  
Hallux Valgus ◽  
Clinical Results ◽  
Soft Tissue Release ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
Chevron Osteotomy ◽  
Valgus Angle ◽  
The Mean ◽  
Severe Hallux Valgus

Background: We compared the radiographic and clinical outcomes of moderate and severe hallux valgus treated by extended distal chevron osteotomy (EDCO) and distal soft tissue release (DSTR). Methods: We performed a retrospective analysis comparing the utility of EDCO for the treatment of moderate (36 patients, 46 feet) and severe (36 patients, 42 feet) hallux valgus. The radiologic outcomes were evaluated based on the preoperative and 3-year follow-up x-rays. The clinical results were investigated based on the 3-year follow-up Manchester-Oxford Foot Questionnaire (MOXFQ), patient satisfaction, and postoperative complications. Results: The mean postoperative intermetatarsal angle, hallux valgus angle, tibial sesamoid position, and relative metatarsal bone length were significantly different compared with the preoperative values for both the moderate and severe groups ( P < .001). At 3-year follow-up, intergroup differences were observed in the mean postoperative intermetatarsal angle ( P = .001), hallux valgus angle ( P = .003), and tibial sesamoid position ( P = .013); however, mean radiographic results were within the normal range for both groups. There were no intergroup differences for either the first metatarsal bone length ( P = .172) or shortening ( P = .621). No significant difference in MOXFQ ( P = .525) was evident between the groups at 3-year follow-up. In satisfaction analysis, 82.6% of the moderate group reported good to excellent results, as did 81.0% of the severe group ( P = .815). A total of 7 complications were reported in each group ( P = 1.000). Conclusion: The present study showed that midterm mean radiographic results of both moderate and severe hallux valgus treated by EDCO with DSTR were favorable, and those values were within the normal range. Clinical outcomes were comparable between the 2 groups, including overall efficacy. Based on these results, we recommend EDCO with DSTR as an efficient and reliable operative option for both moderate and severe hallux valgus. Level of Evidence: Level III, retrospective comparative study.

scholarly journals PO 18115 - Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 15S
Author(s):  
Fábio Lemos Rodrigues ◽  
Luiz Carlos Ribeiro Lara ◽  
Juan Antonio Grajales ◽  
Lucio Carlos Torres
Keyword(s):  
Hallux Valgus ◽  
Hallux Valgus Angle ◽  
Aofas Score ◽  
Intermetatarsal Angle ◽  
First Metatarsal ◽  
Valgus Angle ◽  
Angle Correction ◽  
Age At Surgery ◽  
The Mean

Objective: To analyze the outcomes of percutaneous hallux valgus correction using the Reverdin-Isham osteotomy through clinical and radiographic studies. Methods: We retrospectively evaluated 43 feet in 38 patients with mild or moderate hallux valgus from June 2009 to July 2018. The mean age at surgery was 59 years; the mean postoperative follow-up time was 79 months. All patients treated with the Reverdin technique modified by Isham were evaluated in the pre- and postoperative periods using the American Association Orthopedic Foot and Ankle Society (AOFAS) score; we radiographically measured the hallux valgus angle (HVA), the intermetatarsal angle (IMA) and the first distal metatarsal articular angle (DMAA). Results: The AOFAS score increased by an average of 55 points. On average, the HVA decreased by 14°, the IMA by 3° and the DMAA by 9°. The mean reduction in the length of the first metatarsal bone was 0.3 cm. Conclusion: This surgical technique was effective for hallux valgus correction, demonstrating good angle correction and a marked increase in the AOFAS score.

scholarly journals Z-osteotomy in hallux valgus: clinical and radiological outcome after Scarf osteotomy

2009 ◽  
Vol 1 (1) ◽  
pp. 4 ◽  
Author(s):  
Marcus Jaeger ◽  
Michael Schmidt ◽  
Alexander Wild ◽  
Bernd Bittersohl ◽  
Susanne Courtois ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Mean Value ◽  
Surgical Approaches ◽  
Radiological Outcome ◽  
Scarf Osteotomy ◽  
Post Surgery ◽  
The Mean

Correction osteotomies of the first metatarsal are common surgical approaches in treating hallux valgus deformities whereas the Scarf osteotomy has gained popularity. The purpose of this study was to analyze short- and mid-term results in hallux valgus patients who underwent a Scarf osteotomy. The subjective and radiological outcome of 131 Scarf osteotomies (106 hallux valgus patients, mean age: 57.5 years, range: 22-90 years) were retrospectively analyzed. Mean follow-up was 22.4 months (range: 6 months-5 years). Surgical indications were: intermetatarsal angle (IMA) of 12-23&deg;; increased proximal articular angle (PAA&gt;8&deg;), and range of motion of the metatarsophalangeal joint in flexion and extension &gt;40&deg;. Exclusion criteria were severe osteoporosis and/or osteoarthritis. The mean subjective range of motion (ROM) of the great toe post-surgery was 0.8&plusmn;1.73 points (0: full ROM, 10: total stiffness). The mean subjective cosmetic result was 2.7&plusmn;2.7 points (0: excellent, 10: poor). The overall post-operative patient satisfaction with the result was high (2.1&plusmn;2.5 points (0: excellent, 10: poor). The mean hallux valgus angle improvement was 16.6&deg; (pre-operative mean value: 37.5&deg;) which was statistically significant (p&lt;0.01). The IMA improved by an average of 5.96&deg; from a pre-operative mean value of 15.4&deg; (p&lt;0.01). Neither osteonecrosis of the distal fragment nor peri-operative fractures were noted during the follow-up. In keeping with our follow-up results, the Scarf osteotomy approach shows potential in the therapy of hallux valgus. 筻

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