scholarly journals Bunion foot

2012 ◽  
Vol 140 (7-8) ◽  
pp. 533-536
Author(s):  
Zoran Vukasinovic ◽  
Nadan Mikic

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.

Author(s):  
Asta Samienė ◽  
Vaida Berneckė ◽  
Aurelija Simavičienė

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.


Author(s):  
Timur B. Minasov ◽  
Ekaterina R. Yakupova ◽  
Ruslan F. Khairutdinov ◽  
Dilmurod Ruziboev ◽  
Ruslan M. Vakhitov-Kovalevich ◽  
...  

Hallux valgus (HV) violates the musculoskeletal function of the lower limb, and also affect the x-ray anatomical parameters of the foot. There is the study of the most important correlations between age, morphological and functional changes of the forefoot play a big role in the choice of treatment tactics for this pathology. The aim was to analyze the age, functional and radiological results of surgical treatment of Hallux valgus deformity of the first toe using the methods saving the metatarsophalangeal joint. 126 patients had Hallux valgus deformity of the first toe of I, II, III degree. They were examined before surgery, then 3, 6 and 12 months after operation. 126 patients were operated according to the method of Scarf, Austin, Bosch-Magnan osteotomy. X-ray results were assessed by the Hallux valgus angle (HVA), the intermetatarsal angle (IMA), the distal metatarsal articular angle (DMMA) before and after the operations. AOFAS rating scale (Kitaoka) and biomechanical (stabilometric) study were used for the functional assessment of the surgical treatment results. The IMA correction angle after operation increases with the patient's age. HVA becomes the most deformed angle in the pathology of Hallux valgus with increasing age before osteotomy. The best functional result according to the AOFAS scale was obtained with the greatest correction of the IMA angle after osteotomy. The functional index of the foot decreased with increasing age after osteotomies.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Jie Chen ◽  
Eugene Stautberg ◽  
David Spak ◽  
Gregory Schneider ◽  
Vinod Panchbhavi

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.


Foot & Ankle ◽  
1992 ◽  
Vol 13 (8) ◽  
pp. 447-452 ◽  
Author(s):  
Kosaku Mizuno ◽  
Masataka Hashimura ◽  
Mayako Kimura ◽  
Kazushi Hirohata

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.


2009 ◽  
Vol 3 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Sherif N. G. Bishay ◽  
Mustafa H. El-Sherbini ◽  
Ashraf A. Lotfy ◽  
Hatem M. Abdel-Rahman ◽  
Hany N. Iskandar ◽  
...  

Author(s):  
Yuki Etani ◽  
Makoto Hirao ◽  
Kosuke Ebina ◽  
Takaaki Noguchi ◽  
Gensuke Okamura ◽  
...  

With the progress of medical treatment for rheumatoid arthritis (RA), several joint-preserving forefoot surgical procedures have been established and performed. In this situation, we have been choosing the combined surgery: modified scarf osteotomy for the great toe and metatarsal shortening offset osteotomy for the lesser toes in RA cases. A retrospective observational study of 53 RA patients (mean follow-up period: 4.6 years) who underwent the surgery was completed. RA foot ankle scores were assessed, using the Japanese Society for Surgery of the Foot (JSSF) standard rating system, and a self-administered foot evaluation questionnaire (SAFE-Q) was also checked to evaluate clinical outcomes. For radiological evaluations, deformity parameters were measured using radiographs of the feet with weight-bearing. JSSF hallux and lesser toes scores and the SAFE-Q score showed significant improvement in all indices. HVA, M1-M2A, M1-M5A, M2-M5A, and sesamoid position were significantly improved after surgery. At the final follow-up, the hallux valgus deformity had recurred in 4 feet (7.5%), and hallux varus deformity had developed in 8 feet (15.1%). No case of recurrent hallux valgus deformity required revision surgery. Recurrence of dorsal dislocation/subluxation of the lesser toe MTP joint was seen in 6 feet (11.3%) after surgery. A combination of modified scarf osteotomy for the great toe and modified metatarsal shortening offset osteotomy for the lesser toes is one of the novel surgical procedures for rheumatoid forefoot deformity. Preoperative disease activity of RA negatively affected the clinical score of the hallux. The spread of M2-M5A was a risk factor for resubluxation of the lesser toe MTP joint.


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