• 1. 

    Deschamps K, Birch I & Desloovere K et al.: The impact of hallux valgus on foot kinematics: a cross-sectional, comparative study. Gait Posture 32 : 102, 2010.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 2. 

    Martinez-Nova A, Sanchez-Rodriguez R & Perez-Soriano P et al.: Plantar pressure determinants in mild hallux valgus. Gait Posture 32 : 425, 2010.

  • 3. 

    Waldecker U: Metatarsalgia in hallux valgus deformity: a pedographic analysis. J Foot Ankle Surg 41 : 300, 2002.

  • 4. 

    Suzuki J, Tanaka Y & Takaoka T et al.: Axial radiographic evaluation in hallux valgus: evaluation of the transverse arch in the forefoot. J Orthop Sci 9 : 446, 2004.

  • 5. 

    Gutteck N, Wohlrab D & Zeh A et al.: Comparative study of Lapidus bunionectomy using different osteosynthesis methods. Foot Ankle Surg 19 : 218, 2013.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 6. 

    Klos K, Wilde CH & Lange A et al.: Modified Lapidus arthrodesis with plantar plate and compression screw for treatment of hallux valgus with hypermobility of the first ray: a preliminary report. Foot Ankle Surg 19 : 239, 2013.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 7. 

    Bryant AR, Tinley P & Cole JH: Plantar pressure and radiographic changes to the forefoot after the Austin bunionectomy. JAPMA 95 : 357, 2005.

  • 8. 

    Ramachandra P, Maiya AG & Kumar P: Test-retest reliability of the Win-Track platform in analyzing the gait parameters and plantar pressures during barefoot walking in healthy adults. Foot Ankle Spec 5 : 306, 2012.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9. 

    Plank M: The pattern of forefoot pressure distribution in hallux valgus. Foot 5 : 8, 1995.

  • 10. 

    Hida T, Okuda R & Yasuda T et al.: Comparison of plantar pressure distribution in patients with hallux valgus and healthy matched controls. J Orthop Sci 22 : 1054, 2017.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 11. 

    Hofmann UK, Götze M & Wiesenreiter K et al.: Transfer of plantar pressure from the medial to the central forefoot in patients with hallux valgus. BMC Musculoskelet Disord 20 : 149, 2019.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 12. 

    Kernozek TW & Sterriker SA: Chevron distal metatarsal osteotomy for hallux valgus: comparison of pre-and post surgical characteristics. Foot Ankle Int 23 : 503, 2002.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13. 

    Wen J, Ding Q & Yu Z et al.: Adaptive changes of foot pressure in hallux valgus patients. Gait Posture 36 : 344, 2012.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 14. 

    Bryant A, Tinley P & Singer K: Plantar pressure distribution in normal: hallux valgus and hallux limitus feet. Foot 9 : 115, 1999.

  • 15. 

    Yamamoto H, Muneta T & Asahina S et al.: Forefoot pressures during walking in feet afflicted with hallux valgus. Clin Orthop Relat Res 323 : 247, 1996.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. 

    Geng X, Huang D & Wang X et al.: Loading pattern of postoperative hallux valgus feet with and without transfer metatarsalgia: a case control study. J Orthop Surg Res 12 : 120, 2012.

    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 17. 

    Koller U, Willegger M & Windhager R et al.: Plantar pressure characteristics in hallux valgus feet. J Orthop Res 32: 1688e93, 2014.

    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 18. 

    Jonely H, Brismée JM & Sizer PS Jr, et al.: Relationships between clinical measures of static foot posture and plantar pressure during static standing and walking. Clin Biomech 26 : 873, 2011.

    • Crossref
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 19. 

    Brodsky JW, Beicher AD & Robinson AH et al.: Surgery for hallux valgus with proximal crescentic osteotomy causes variable postoperative pressure patterns. Clin Orthop Relat Res 443 : 280, 2006.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20. 

    Wanivenhaus A & Brettschneider W: Influence of metatarsal head displacement on metatarsal pressure distribution after hallux valgus surgery. Foot Ankle 14 : 85, 1993.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21. 

    Gutteck N, Savov P & Panian M et al.: Preliminary results of a plantar plate for Lapidus arthrodesis. Foot Ankle Surg 24 : 383, 2018.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation

Effect of Proximal Dome and Distal Chevron Osteotomies on Plantar Pressures and Radiographic and Functional Outcomes in Hallux Valgus Surgery: A Retrospective Analysis

Restricted access

Background

No detailed comparative studies have been performed regarding plantar pressure changes between proximal dome and distal chevron osteotomies. This study aimed to compare radiographic and plantar pressure changes after distal chevron and proximal dome osteotomies and to investigate the effect of radiographic and plantar pressure changes on clinical outcomes.

Methods

This study included 26 and 22 patients who underwent distal chevron and proximal dome osteotomies, respectively. Visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) forefoot scores were used to evaluate pain and functional outcomes. Hallux valgus angle, intermetatarsal angle, talar–first metatarsal angle, and calcaneal inclination angle were measured in the evaluation of radiographic outcomes. Preoperative and postoperative plantar pressure changes were evaluated.

Results

There were no statistically significant differences between the two groups in age, body mass index, or AOFAS forefoot and VAS scores. In the proximal dome group, the pressure measurement showed significant lateralization of the maximal anterior pressure point in the forefoot (P < .001). In addition, the postoperative calcaneal inclination angle was significantly lower (P = .004) and the talar–first metatarsal angle was significantly higher (P < .001) in the proximal dome group. Postoperative transfer metatarsalgia was observed in one patient (3.8%) in the distal chevron group and five (22.7%) in the proximal dome group (P < .05).

Conclusions

Proximal dome osteotomy led to more lateralization of the maximum anterior pressure point, decreased calcaneal inclination angle and first metatarsal elevation, and related higher transfer metatarsalgia.

Department of Orthopaedics and Traumatology, Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.

Department of Orthopaedics and Traumatology, Health Sciences University, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.

Department of Orthopaedics and Traumatology, Bursa Cekirge State Hospital, Bursa, Turkey.

Corresponding author: Kadir Ilker Yildiz, MD, Department of Orthopaedics and Traumatology, Baltalimani Bone Diseases Training and Research Hospital, Rumelihisari Cad. No:56 Sariyer, Istanbul, 34335 Turkey. (E-mail: kadirilkeryildiz@yahoo.com)