Plantar Pressure and Radiographic Changes to the Forefoot After the Austin Bunionectomy

2005 ◽  
Vol 95 (4) ◽  
pp. 357-365 ◽  
Author(s):  
Alan R. Bryant ◽  
Paul Tinley ◽  
Joan H. Cole
Keyword(s):  
Hallux Valgus ◽  
Plantar Pressure ◽  
Peak Pressure ◽  
Normal Values ◽  
Valgus Deformity ◽  
Pressure Measurements ◽  
First Metatarsal ◽  
Plantar Pressure Distribution ◽  
Hallux Valgus Deformity ◽  
Radiographic Measurements

We describe the effects of the Austin bunionectomy on plantar pressure distribution and radiographic measurements in the forefoot in 31 subjects (44 feet) with mild-to-moderate hallux valgus deformity and 36 control subjects (36 feet). Plantar pressure measurements before and 24 months after surgery showed peak pressure beneath the hallux reduced to normal values. Peak pressure measurements beneath the first, second, and third metatarsal heads in hallux valgus feet were relatively unchanged after surgery and remained higher than normal values. The operation produced significant decreases in mean preoperative radiographic measurements of hallux abductus, metatarsus primus varus, and first metatarsal protrusion distance in these patients to below-normal values. (J Am Podiatr Med Assoc 95(4): 357–365, 2005)

Effect of Metatarsal Head Shape on the Development of Hallux Valgus Deformity: 10 Years of Natural Follow-up

2020 ◽  
Vol 110 (3) ◽  
Author(s):  
Ulunay Kanatli ◽  
Onur Unal ◽  
Muhammet Baybars Ataoglu ◽  
Tacettin Ayanoglu ◽  
Mustafa Ozer ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Plantar Pressure ◽  
Metatarsal Head ◽  
Valgus Deformity ◽  
Radiographic Evaluation ◽  
Hallux Valgus Angle ◽  
Head Shape ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
Valgus Angle

Background We investigated the role of first metatarsal head shape in the etiology of hallux valgus. By pedobarographic analysis, we evaluated whether first metatarsal head shape causes an alteration in plantar pressure values that would result in metatarsalgia. Methods Referrals to our clinic for metatarsalgia, plantar fasciitis, and calcaneal spur were scanned retrospectively. Patients with severe hallux valgus, pes planus, gastrocnemius stiffness, generalized joint laxity, neuromuscular disease, or a history of lower-extremity orthopedic surgery were excluded. Sixty-two patients with plantar pressure assessment and radiographic evaluation were included. These patients were invited for reassessment after 10 years. Feet were divided into three groups by metatarsal head shape: round, square, and chevron. On anteroposterior radiographs, the hallux valgus and intermetatarsal angles, relative first metatarsal length, lateral sesamoid subluxation, and presence of bipartite sesamoid were noted. Plantar pressure was assessed with pedobarography. Results Feet with round-shaped first metatarsal heads had a statistically significantly greater progression in hallux valgus angle than the other shapes. Plantar pressures under the first, second and third, and fourth and fifth metatarsals increased with time. This can explain the mechanism of transfer metatarsalgia and painful callosities under the first metatarsal in hallux valgus. There was no correlation between hallux valgus angle, relative metatarsal length, and lateral sesamoid subluxation. Conclusions We found a strong relation between round-shaped first metatarsal head and hallux valgus angle progression. No patients had a risk factor responsible for hallux valgus. In other words, this study gives approximately 10-year natural history results in nearly normal feet.

Radiographic Measurements Associated With the Natural Progression of the Hallux Valgus During at Least 2 Years of Follow-up

2018 ◽  
Vol 39 (4) ◽  
pp. 463-470 ◽  
Author(s):  
Seung Yeol Lee ◽  
Chin Youb Chung ◽  
Moon Seok Park ◽  
Ki Hyuk Sung ◽  
Sonya Ahmed ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Binary Logistic Regression ◽  
Valgus Deformity ◽  
Binary Logistic Regression Analysis ◽  
Level Of Evidence ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
Metatarsal Angle ◽  
Radiographic Measurements

Background: This study aimed to investigate the radiographic measurements associated with the progression of hallux valgus during at least 2 years of follow-up. Methods: Seventy adult patients with hallux valgus who were followed for at least 2 years and underwent weightbearing foot radiography were included. Radiographic measurements included the hallux valgus angle (HVA), hallux interphalangeal angle, intermetatarsal angle (IMA), metatarsus adductus angle, distal metatarsal articular angle (DMAA), tibial sesamoid position, anteroposterior (AP) talo–first metatarsal angle, and lateral talo–first metatarsal angle. Patients were divided into progressive and nonprogressive groups. Binary logistic regression analysis was performed to identify factors that significantly affected the progression of hallux valgus deformity. The correlation between change in HVA and changes in other radiographic indices during follow-up was analyzed. Results: The DMAA ( P = .027) and AP talo–first metatarsal angle ( P = .034) at initial presentation were found to be significant factors affecting the progression of hallux valgus deformity. Change in the HVA during follow-up was significantly correlated with changes in the IMA ( r = 0.423; P = .001) and DMAA ( r = 0.541; P < .001). Conclusion: The change in the HVA was found to be significantly correlated with changes in the IMA and DMAA. A future study is required to elucidate whether this correlation can be explained by the progressive instability of the first tarsometatarsal joint. We believe special attention needs to be paid to patients with pes planus and increased DMAA. Level of Evidence: Level III, comparative study.

scholarly journals Radiographic Measurements Associated with the Natural Progression of the Hallux Valgus Deformity during at Least Two Years of Follow-up

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002 ◽  
Author(s):  
Kyoung Min Lee ◽  
Seung Yeol Lee ◽  
Sonya Ahmed ◽  
Byung Chae Cho ◽  
Moon Seok Park ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Binary Logistic Regression ◽  
Valgus Deformity ◽  
Binary Logistic Regression Analysis ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
Metatarsal Angle ◽  
Radiographic Measurements

Category: Bunion Introduction/Purpose: There have been few longitudinal studies regarding hallux valgus deformity. This retrospective study aimed to investigate the radiographic measurements associated with the progression of hallux valgus deformity during at least two years of follow-up. Methods: Seventy adult patients (mean age, 58.0 years; standard deviation [SD], 12.3 years; 13 males and 57 females) with hallux valgus who were followed-up for at least two years and underwent weight-bearing foot radiography were included. Radiographic measurements included the hallux valgus angle (HVA), hallux interphalangeal angle, intermetatarsal angle (IMA), metatarsus adductus angle, distal metatarsal articular angle (DMAA), tibial sesamoid position, anteroposterior (AP) talo-first metatarsal angle, and lateral talo-first metatarsal angle. Progression of hallux valgus deformity was defined as an increase of 5 degrees or more in the HVA during follow-up. Patients were divided into progressive and non-progressive groups. Binary logistic regression analysis was performed to identify factors that significantly affect the progression of hallux valgus deformity. The correlation between change in HVA and changes in other radiographic indices during follow-up was analyzed. Results: Eighteen out of 70 patients showed progression of 5 degrees or more in the HVA during the mean follow-up of 47.0 months (SD, 19.8 months). The DMAA (p=0.027) and AP talo-first metatarsal angle (p=0.034) at initial presentation were found to be significant factors affecting the progression of hallux valgus deformity. Change in the HVA during follow-up was significantly correlated with changes in the IMA (r=0.423; p=0.001) and DMAA (r=0.541; p<0.001). Conclusion: Special attention needs to be given to patients with pes planovalgus and increased DMAA during follow-up. Change in HVA was significantly correlated with changes in IMA and DMAA. Therefore, progression of hallux valgus deformity is considered to be closely related to the progressive instability of the first tarsometatarsal joint.

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.

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.

Comparison of Postoperative Height Changes of the Second Metatarsal Among 3 Osteotomy Methods for Hallux Valgus Deformity Correction

2016 ◽  
Vol 38 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Jun Young Choi ◽  
Yu Min Suh ◽  
Ji Woong Yeom ◽  
Jin Soo Suh
Keyword(s):  
Hallux Valgus ◽  
Deformity Correction ◽  
Metatarsal Head ◽  
Valgus Deformity ◽  
Metatarsal Osteotomy ◽  
Level Of Evidence ◽  
First Metatarsal ◽  
Scarf Osteotomy ◽  
Hallux Valgus Deformity ◽  
Second Metatarsal

Background: We aimed to compare the postoperative height of the second metatarsal head relative to the first metatarsal head using axial radiographs among 3 different commonly used osteotomy techniques: proximal chevron metatarsal osteotomy (PCMO), scarf osteotomy, and distal chevron metatarsal osteotomy (DCMO). Methods: We retrospectively reviewed the radiographs and clinical findings of the patients with painful callosities under the second metatarsal head, complicated by hallux valgus, who underwent isolated PCMO, scarf osteotomy, or DCMO from February 2005 to January 2015. Each osteotomy was performed with 20 degrees of plantar ward obliquity. Along with lateral translation and rotation of the distal fragment to correct the deformity, lowering of the first metatarsal head was made by virtue of the oblique metatarsal osteotomy. Results: Significant postoperative change in the second metatarsal height was observed on axial radiographs in all groups; this value was greatest in the PCMO group (vs scarf: P = .013; vs DCMO: P = .008) but did not significantly differ between the scarf and DCMO groups ( P = .785). The power for second metatarsal height correction was significantly greater in the PCMO group (vs scarf: P = .0005; vs DCMO: P = .0005) but did not significantly differ between the scarf and DCMO groups ( P = .832). Conclusions: Among the 3 osteotomy techniques commonly used to correct hallux valgus deformity, we observed that PCMO yielded the most effective height change of the second metatarsal head. Level of Evidence: Level III, retrospective comparative series.

scholarly journals Dynamic First Tarsometatarsal Instability During Gait Evaluated by Pedobarographic Examination in Patients with Hallux Valgus

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0030
Author(s):  
Byung Jo Min ◽  
Seungbum Koo ◽  
Won-keun Park ◽  
Ki-bum Kwon ◽  
Kyoung Min Lee
Keyword(s):  
Hallux Valgus ◽  
Joint Instability ◽  
Weight Bearing ◽  
Binary Logistic Regression ◽  
Valgus Deformity ◽  
Binary Logistic Regression Analysis ◽  
Tarsometatarsal Joint ◽  
Hallux Valgus Deformity ◽  
Metatarsal Angle ◽  
Radiographic Measurements

Category: Midfoot/Forefoot Introduction/Purpose: This study aimed to investigate the pedobarographic characteristics of tarsometatarsal instability and to identify factors associated with pedobarographic first tarsometatarsal instability in patients with hallux valgus deformity. Methods: Fifty-seven patients (mean age, 59.7 years; standard deviation, 11.4 years; 6 men and 51 women) with a hallux valgus angle (HVA) greater than 15° were included. All patients underwent a pedobarographic examination along with weight-bearing anteroposterior (AP) and lateral foot radiography. Radiographic measurements were compared between the two groups with and without pedobarographic first tarsometatarsal instability. The association between the radiographic and pedobarographic parameters of the first tarsometatarsal instability was analyzed using the chi-square test. Binary logistic regression analysis was performed to identify significant factors affecting pedobarographic first tarsometatarsal instability. Results: HVA (p<0.001), the intermetatarsal angle (p=0.001), and AP talo-first metatarsal angle were significantly different between the pedobarographically stable and unstable tarsometatarsal groups. There was no significant association between radiographic and pedobarographic instabilities of the first tarsometatarsal joint (p=0.924). HVA was found to be the only significant factor affecting pedobarographic tarsometatarsal joint instability (p=0.001). Conclusion: The pedobarographic examination has possible clinical utility in evaluating first tarsometatarsal joint instability in patients with hallux valgus deformity. Patients with greater HVA need to be carefully monitored for the presence of first tarsometatarsal instability, and the necessity of the Lapidus procedure should be considered.

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