scholarly journals Hallux Valgus and the First Metatarsal Arch Segment: A Theoretical Biomechanical Perspective

2010 ◽  
Vol 90 (1) ◽  
pp. 110-120 ◽  
Author(s):  
Ward M. Glasoe ◽  
David J. Nuckley ◽  
Paula M. Ludewig
Keyword(s):  
Hallux Valgus ◽  
Late Stage ◽  
Foot Orthoses ◽  
Foot Deformity ◽  
Lateral Deviation ◽  
Vertical Orientation ◽  
First Metatarsal

Hallux valgus is a progressive foot deformity characterized by a lateral deviation of the hallux with corresponding medial deviation of the first metatarsal. Late-stage changes may render the hallux painful and without functional utility, leading to impaired gait. Various environmental, genetic, and anatomical predispositions have been suggested, but the exact cause of hallux valgus is unknown. Evidence indicates that conservative intervention for hallux valgus provides relief from symptoms but does not reverse deformity. Part 1 of this perspective article reviews the literature describing the anatomy, pathomechanics, and etiology of hallux valgus. Part 2 expands on the biomechanical initiators of hallux valgus attributed to the first metatarsal. Theory is advanced that collapse of the arch with vertical orientation (tilt) of the first metatarsal axis initiates deformity. To counteract the progression of hallux valgus, we use theory to discuss a possible mechanism by which foot orthoses can bolster the arch and reorient the first metatarsal axis horizontally.

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

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.

scholarly journals THE THE RELATIONSHIP BETWEEN PROLONGED STANDING AND HALLUX VALGUS IN SALESPERSON

2018 ◽  
Vol 6 (2) ◽  
pp. 11
Author(s):  
Galuh Aullia Pratiwi ◽  
I Made Niko Winaya ◽  
Dewa Ayu Inten Primayanti
Keyword(s):  
Hallux Valgus ◽  
Significant Relationship ◽  
Measuring Instruments ◽  
Lateral Deviation ◽  
Cross Sectional ◽  
Prolonged Standing ◽  
First Metatarsal ◽  
Rotation Factor ◽  
The Relationship

ABSTRAK Hallux valgus is a condition if first metatarsal medial deviation and thumb or hallux lateral deviation and rotation. Factor that affected was the prolonged standing use of constrictive footwear such as high-heeled shoes. Prolonged standing was standing with  more than 4 hours per day.This study was cross sectional analytic observation and 62 female salesperson who worked in Mall X were selected to be sample. Measuring instruments used to determine the hallux valgus was using the Manchester scale. This study was shown there wes a significant relationship between prolonged standing and hallux valgus in female salesperson p = 0.007 (p <0.05). From 62 female salesperson, the were 46 who had hallux valgus, in which 43 persons worked with longterm standing (93.5%) and 3 persons (6.5%) worked without longterm standing. However, from 16 salesperson who had not hallux valgus, there was 10 persons (62.5%) worked with longterm standing and 6 persons worked without longterm. Keywords : Hallux valgus, Prolonged standing, salesperson

Effect of medial arch support foot orthosis on plantar pressure distribution in females with mild-to-moderate hallux valgus after one month of follow-up

2014 ◽  
Vol 39 (2) ◽  
pp. 134-139 ◽  
Author(s):  
Maede Farzadi ◽  
Zahra Safaeepour ◽  
Mohammad E Mousavi ◽  
Hassan Saeedi
Keyword(s):  
Pressure Distribution ◽  
Hallux Valgus ◽  
Plantar Pressure ◽  
Peak Pressure ◽  
Foot Orthoses ◽  
First Metatarsal ◽  
Plantar Pressure Distribution ◽  
Before And After ◽  
Arch Support ◽  
Foot Orthosis

Background:Higher plantar pressures at the medial forefoot are reported in hallux valgus. Foot orthoses with medial arch support are considered as an intervention in this pathology. However, little is known about the effect of foot orthoses on plantar pressure distribution in hallux valgus.Objectives:To investigate the effect of a foot orthosis with medial arch support on pressure distribution in females with mild-to-moderate hallux valgus.Study design:Quasi-experimental.Methods:Sixteen female volunteers with mild-to-moderate hallux valgus participated in this study and used a medial arch support foot orthosis for 4 weeks. Plantar pressure for each participant was assessed using the Pedar-X®in-shoe system in four conditions including shoe-only and foot orthosis before and after the intervention.Results:The use of the foot orthosis for 1 month led to a decrease in peak pressure and maximum force under the hallux, first metatarsal, and metatarsals 3–5 ( p < 0.05). In the medial midfoot region, peak pressure, maximum force, and contact area were significantly higher with the foot orthosis than shoe-only before and after the intervention ( p = 0.00).Conclusion:A foot orthosis with medial arch support could reduce pressure beneath the hallux and the first metatarsal head by transferring the load to the other regions. It would appear that this type of foot orthosis can be an effective method of intervention in this pathology.Clinical relevanceFindings of this study will improve the clinical knowledge about the effect of the medial arch support foot orthosis used on plantar pressure distribution in hallux valgus pathology.

scholarly journals Practicing various sports disciplines and their impact on the occurrence of hallux valgus

2021 ◽  
Vol 10 (2) ◽  
pp. 51-53
Author(s):  
Marek Mikuła ◽  
◽  
Karolina Bogdan ◽  
Keyword(s):  
Hallux Valgus ◽  
Lower Limb ◽  
Morphological Structure ◽  
Medical Problem ◽  
Metatarsal Bone ◽  
The Body ◽  
Lateral Deviation ◽  
First Metatarsal ◽  
High Heels ◽  
Supporting Element

The foot is an important supporting element of the body. The deformity that may arise in the area of the toes is hallux valgus. It consists in the lateral deviation of the toe and the medial displacement of the first metatarsal bone. It is a medical problem and affects the aesthetics and symmetry of the feet. The aim of the study was to present how selected sports disciplines affect the morphological structure of the feet, with emphasis on the formation of hallux valgus. Regular physical activity strengthens the muscles and ligaments of the foot. Most sports do not lead to the formation of hallux valgus, also they can slow down the process of its formation. More frequent occurrence of hallux valgus among female dancers may be due to the wearing of high heels. Foot defects may also appear in people who, as a result of practicing sports, suffer injuries in the distal parts of the lower limb and in those with an increased Body Mass Index.

scholarly journals HALLUX VALGUS ANATOMICAL ALTERATIONS AND ITS CORRELATION WITH THE RADIOGRAPHIC FINDINGS

2020 ◽  
Vol 28 (1) ◽  
pp. 12-15
Author(s):  
Cristina Schmitt Cavalheiro ◽  
Marcel Henrique Arcuri ◽  
Victor Reis Guil ◽  
Julio Cesar Gali
Keyword(s):  
Hallux Valgus ◽  
Case Series ◽  
Metatarsal Head ◽  
Abductor Muscle ◽  
Lateral Deviation ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Longus Tendon ◽  
First Metatarsal ◽  
Extensor Hallucis Longus

ABSTRACT Objective: To describe the anatomical and pathological osteoarticular, muscular and tendinous variations in feet of cadavers with hallux valgus and to correlate them with the degree of radiographic deformity. Methods: Dissections and radiographs were conducted in the feet of 22 cadavers with halux valgus, aged between 20 and 70 years. The feet affected were compared with 5 normal feet in order to document the anatomical and pathological, myotendinous and articular variations found. Results: The extensor hallucis longus and brevis tendons were arched in all degrees of deformity, causing a lateral deviation that forms the arc chord of the metatarsophalangeal angle of the hallux. We also observed a deviation to the plantar face of the abductor muscle tendon and lateral deviation of the flexor hallucis muscle tendon. In the moderate deformities, the medial deviation of the first metatarsal head was observed, sliding out of the sesamoid apparatus, pronation of this head, and formation of medial exostoses. In severe deformities, in addition to all other deformities, we found the extensor hallucis longus tendon with two distal insertions, rather than just one. Conclusion: The anatomical alterations found in the hallux valgus may be related to the degree of radiographic deformity . Level of Evidence IV, Case series.

First Metatarsal Rotation in Hallux Valgus Deformity

2021 ◽  
Vol 42 (4) ◽  
pp. 510-522
Author(s):  
Jesse Steadman ◽  
Alexej Barg ◽  
Charles L. Saltzman
Keyword(s):  
Hallux Valgus ◽  
Potential Role ◽  
Axial Rotation ◽  
Valgus Deformity ◽  
Measurement Methods ◽  
Advanced Imaging ◽  
Level Of Evidence ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
Biplanar Radiographs

Rotation of the first metatarsal (M1) as a potential etiological factor of hallux valgus (HV) deformity was described relatively early in the description of HV pathoanatomy. However, because biplanar radiographs have been the standard method for imaging HV, clinicians primarily developed measurement methods and corrective operations confined to 2 dimensions, medial-lateral and inferior-superior. Recently, as our understanding of HV pathoanatomy has further developed, aided in part by advanced imaging technology, M1 rotation about its axis (“axial rotation”) and its implications for HV deformity and treatment has reemerged. The goal of this review is to summarize M1 rotation in HV from a historical perspective, to present the current understanding of its potential role in the etiology/pathogenesis of HV, and to summarize relevant imaging and operative considerations with respect to M1 rotation. Level of Evidence: Level III, systematic review.

Planning tool for first metatarsal length in hallux valgus surgery

The Foot ◽  
2021 ◽  
Vol 46 ◽  
pp. 101774
Author(s):  
Stephan H. Wirth ◽  
Philipp Fuernstahl (Fürnstahl) ◽  
Dominik C. Meyer ◽  
Arnd F. Viehoefer (Viehöfer)
Keyword(s):  
Hallux Valgus ◽  
Planning Tool ◽  
First Metatarsal

Correlation of Different Methods of Measuring Pronation of the First Metatarsal on Weightbearing CT Scans

2021 ◽  
pp. 107110072110030
Author(s):  
Matthew S. Conti ◽  
Tamanna J. Patel ◽  
Kristin C. Caolo ◽  
Joseph M. Amadio ◽  
Mark C. Miller ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Computer Aided Design ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
3 Dimensional ◽  
3D Cad ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
Second Metatarsal ◽  
Α Angle

Background: There is no consensus in the foot and ankle literature regarding how to measure pronation of the first metatarsal in patients with hallux valgus. The primary purpose of this study was to compare 2 previously published methods for measuring pronation of the first metatarsal and a novel 3-dimensional measurement of pronation to determine if different measurements of pronation are associated with each other. Methods: Thirty patients who underwent a modified Lapidus procedure for their hallux valgus deformity were included in this study. Pronation of the first metatarsal was measured on weightbearing computed tomography (WBCT) scans using the α angle with reference to the floor, a 3-dimensional computer-aided design (3D CAD) calculation with reference to the second metatarsal, and a novel method, called the triplanar angle of pronation (TAP), that included references to both the floor (floor TAP) and base of the second metatarsal (second TAP). Pearson’s correlation coefficients were used to determine if the 3 calculated angles of pronation correlated to each other. Results: Preoperative and postoperative α angle and 3D CAD had no correlation with each other ( r = 0.094, P = .626 and r = 0.076, P = .694, respectively). Preoperative and postoperative second TAP and 3D CAD also had no correlation ( r = 0.095, P = .624 and r = 0.320, P = .09, respectively). However, preoperative and postoperative floor TAP and α angle were found to have moderate correlations ( r = 0.595, P = .001 and r = 0.501, P = .005, respectively). Conclusion: The calculation of first metatarsal pronation is affected by the reference and technique used, and further work is needed to establish a consistent measurement for the foot and ankle community. Level of Evidence: Level III, retrospective cohort study.

Geometric Data of Hallux Valgus Feet

1996 ◽  
Vol 17 (9) ◽  
pp. 548-554 ◽  
Author(s):  
Kenneth S. Lamur ◽  
Anton Huson ◽  
Chris J. Snijders ◽  
Rob Stoeckart
Keyword(s):  
Hallux Valgus ◽  
Least Squares Method ◽  
Metatarsal Bone ◽  
Flexor Hallucis Longus ◽  
Independent Variables ◽  
First Metatarsal ◽  
Linear Dependency ◽  
Geometric Data ◽  
Longus Muscle ◽  
Stepwise Procedure

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.

scholarly journals First-Tarsometatarsal Joint Alignment After First-Metatarsophalangeal Joint Arthrodesis for Hallux Valgus

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110085
Author(s):  
Christopher Traynor ◽  
James Jastifer
Keyword(s):  
Hallux Valgus ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
First Metatarsophalangeal Joint ◽  
First Metatarsal ◽  
Metatarsal Angle ◽  
Medial Cuneiform ◽  
Radiographic Alignment

Background: Instability of the first-tarsometatarsal (TMT) joint has been proposed as a cause of hallux valgus. Although there is literature demonstrating how first-TMT arthrodesis affects hallux valgus, there is little published on how correction of hallux valgus affects the first-TMT joint alignment. The purpose of this study was to determine if correction of hallux valgus impacts the first-TMT alignment and congruency. Improvement in alignment would provide evidence that hallux valgus contributes to first-TMT instability. Our hypothesis was that correcting hallux valgus angle (HVA) would have no effect on the first-TMT alignment and congruency. Methods: Radiographs of patients who underwent first-MTP joint arthrodesis for hallux valgus were retrospectively reviewed. The HVA, 1-2 intermetatarsal angle (IMA), first metatarsal–medial cuneiform angle (1MCA), medial cuneiform–first metatarsal angle (MC1A), relative cuneiform slope (RCS), and distal medial cuneiform angle (DMCA) were measured and recorded for all patients preoperatively and postoperatively. Results: Of the 76 feet that met inclusion criteria, radiographic improvements were noted in HVA (23.6 degrees, P < .0001), 1-2 IMA (6.2 degrees, P < .0001), 1MCA (6.4 degrees, P < .0001), MC1A (6.5 degrees, P < .0001), and RCS (3.3 degrees, P = .001) comparing preoperative and postoperative radiographs. There was no difference noted with DMCA measurements (0.5 degrees, P = .53). Conclusion: Our findings indicate that the radiographic alignment and subluxation of the first-TMT joint will reduce with isolated treatment of the first-MTP joint. Evidence suggests that change in the HVA can affect radiographic alignment and subluxation of the first-TMT joint. Level of Evidence: Level IV, retrospective case series.

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