Search Results
The Grading of Hallux Valgus
The Manchester Scale
This article describes a new, noninvasive method of assessing the severity of hallux valgus deformity by means of a set of standardized photographs. Six podiatrists were independently asked to grade the level of deformity of 13 subjects (26 feet) on a scale of 1 (no deformity) to 4 (severe deformity). The reliability of the four-point scale for the severity of hallux valgus was investigated by means of kappa-type statistics for more than two raters. The results showed that the grading method had excellent interobserver repeatability with a combined kappa-type statistic of 0.86, making it a suitable instrument for clinical and research purposes. (J Am Podiatr Med Assoc 91(2): 74-78, 2001)
Twenty-six patients with moderate-to-severe hallux valgus deformities were evaluated before and after treatment. All of the patients had incongruent great toe joints. The patients underwent modified proximal crescentic osteotomy, which was termed proximal oblique crescentic osteotomy. The results were evaluated at an average follow-up time of 55 weeks. Objective criteria were hallux valgus angle, intermetatarsal angle, shortening of the first metatarsal, and angulation at the osteotomy site. Clinical evaluation was made according to the rating system of the American Orthopaedic Foot and Ankle Society. The mean correction of the hallux valgus and intermetatarsal angles was 22.1° and 9.9°, respectively. Short-term results indicate that proximal oblique crescentic osteotomy is effective in the treatment of hallux valgus; its advantages over other procedures include its technical ease and low rate of complications. (J Am Podiatr Med Assoc 94(1): 43-46, 2004)
Scarf Osteotomy for Hallux Valgus Deformity
A Prospective Study with 8 Years of Clinical and Radiologic Follow-up
Background: Scarf midshaft metatarsal osteotomy has become increasingly popular as a treatment option for moderate-to-severe hallux valgus deformities because of its great versatility. Numerous studies on Scarf osteotomy have been published. However, no prospective studies were available until 2002. Since then, only short-term follow-up prospective studies have been published. We present the results of a prospective study of 21 patients treated by Scarf osteotomy for hallux valgus with follow-up of 8 years.
Methods: Between August 1, 1999, and October 31, 1999, 23 patients (23 feet) with moderate-to-severe hallux valgus deformity were included. Clinical (American Orthopaedic Foot and Ankle Society score) and radiologic (hallux valgus angle, first intermetatarsal angle, and sesamoid position) evaluations were performed preoperatively and 1 and 8 years postoperatively.
Results: Clinical evaluation showed a significant improvement in the mean forefoot score from 47 to 83 (of a possible 100) at 1 year (P < .001). Radiographic evaluation showed significant improvement in the hallux valgus angle (mean improvement, 19°; P < .001) and in the intermetatarsal angle (mean improvement, 6°; P < .001). These clinical and radiographic results were maintained at the final evaluation 8 years postoperatively.
Conclusions: Scarf osteotomy tends to provide predictable and sustainable correction of moderate-to-severe hallux valgus deformities. (J Am Podiatr Med Assoc 100(1): 35–40, 2010)
Abstract
Background: It’s well known fact that Hallux valgus (HV) alternates foot biomechanics. In different populations HV and postural stability has been studied but HV and adolescent ballet dancer has not been studied. Aim of the our study is to explore affect of HV on adolescent ballet dancers’ balance. Also we wanted to explore health related quality of life of adolescent ballet dancers with HV.
Methods: Ballets aged between 8-16 years old has been screened prospectively. The dancers divided into two groups group 1;Ballets with HV and group 2; Ballets without HV. HV diagnosis was made clinically. Two groups were compared according to balance parameters and health related quality of life (HRQOL) questionaires.
Results: Group 1 was formed with 31 participants and group 2 was formed with 24 participants. All participants in both groups were female. Mean age in group 1 was 11.6 (8-16 years old) and 12.2 (8-16 years old) in group 2. Mean first metatarsophalangeal angle was 13.4° (10°-15°) in group 2 and 19.8° (16°-25°) in HV group respectively. A statistically significant difference was found according to the nonparametric Mann Whitney U test results in the comparison of HVA (Hallux Valgus Angle) between groups. According to Spearman Rho correlation analysis, it was determined that the increase in HVA caused deterioration in the static Flamingo test. (r=0.552 p=0.019). No significant relationship was found between HRQoL questionaries and the presence of HV. (p>0,05)
Conclusions: Adolescent ballet dancers experience static balance impairment due to HV angle increase. Clinical measurement of HV and application of balance parameters made easy without need of set ups to perform evaluation with high numbers of participants in concordance with literature.
Nonunion of the first metatarsal after hallux valgus surgery is a rare complication that often results in significant pain and disability requiring surgical management. We report the case of a 42-year-old woman who developed a pseudarthrosis of the first metatarsal after percutaneous retrocapital distal osteotomy of the first metatarsal for a mild hallux valgus deformity. The operative treatment consisted of debridement of fibrous nonunion with plating followed by application of pulsed electromagnetic fields (PEMF) with an external device. (J Am Podiatr Med Assoc 102(1): 78–82, 2012)
Background
The aim of this study was to evaluate the information quality of YouTube videos on hallux valgus.
Methods
A YouTube search was performed using the phrase “hallux valgus” to determine the first 300 videos related to hallux valgus. A total of 54 videos met our inclusion criteria and were evaluated for information quality by using DISCERN, Journal of the American Medical Association (JAMA), and hallux valgus information assessment (HAVIA) scores. Number of views, time since the upload date, view rate, number of comments, number of likes, number of dislikes, and video power index values were calculated to determine video popularity. Information regarding video length (in seconds), video source, and video content was also noted. The relation between information quality and these factors were statistically evaluated.
Results
The mean DISCERN score was 30.35 ± 11.56 (poor quality) (range, 14–64), the mean JAMA score was 2.28 ± 0.96 (range, 1–4), and the mean HAVIA score was 3.63 ± 2.42 (moderate quality) (range, 0.5–8.5). Although videos uploaded by physicians had higher mean DISCERN, JAMA, and HAVIA scores than videos uploaded by nonphysicians, the difference was not statistically significant. In addition, view rates and video power index values were higher for videos uploaded by health channels, but the difference did not reach statistical significance. A statistically significant positive correlation was found between video length and DISCERN (r = 0.294; P = .028), and HAVIA scores (r = 0.326; P = .015).
Conclusions
This study demonstrated that the quality of information available on YouTube videos about hallux valgus was low and insufficient. Videos containing accurate information from reliable sources are needed to educate patients on hallux valgus, especially with regard to less frequently mentioned topics such as postoperative complications and healing period.
Background:
Resection of the medial eminence in hallux valgus surgery is common. True hypertrophy of the medial eminence in hallux valgus is debated. No studies have compared metatarsal head width in patients with hallux valgus and control patients.
Methods:
We reviewed 43 radiographs with hallux valgus and 27 without hallux valgus. We measured medial eminence width, first metatarsal head width, and first metatarsal shaft width in patients with and without radiographic hallux valgus.
Results:
Medial eminence width was 1.12 mm larger in patients with hallux valgus (P < .0001). Metatarsal head width was 2.81 mm larger in patients with hallux valgus (P < .001). Metatarsal shaft width showed no significant difference (P = .63).
Conclusions:
Metatarsal head width and medial eminence width are significantly larger on anteroposterior weightbearing radiographs in patients with hallux valgus. However, frontal plane rotation of the first metatarsal likely accounts for this difference.
Hallux valgus is the most common orthopedic problem of the adult foot. The etiology can be congenital, associated with the occurrence of metatarsus primus varus, or acquired, which is closely related to wearing ill-fitting shoes. Hallux valgus occurs almost exclusively in shod societies and, therefore, is a very uncommon finding in archaeological remains. We present a partial first ray of the left foot belonging to a dismembered Egyptian mummy recovered in the necropolis of Sharuna (Middle Egypt) and dated to the end of the Old Kingdom (circa 2100 BC). The mummification process led to a metatarsophalangeal joint in connection by means of soft tissues. The alignment of this joint could be diagnosed as a hallux valgus. Further examination showed a metatarsophalangeal angle of 28°. After a comprehensive literature search and noting that all of the previous cases were described by indirect factors, such as mounting the joint in dry bones, we can state with certainty that the piece we present herein is the oldest case of mummified hallux valgus.
Abstract
Background: Distal osteotomy of the first metatarsal is a widely used method for the correction of mild-to-moderate hallux valgus deformities. The objective of this study was to compare the stability of headless compression screws, kirschner wires and absorbable pins in terms of stiffness and maximum load in distal oblique metatarsal osteotomy.
Methods: A total of 30 4th generation first metatarsal synthetic bone models were divided into three groups according to the fixation techniques. The stiffness of the first metatarsal was calculated as the slope of the linear curve that fit with the first linear part of the force displacement curve. The failure strength was recorded as the maximum load. The stiffness and maximum load values in the axillary and transverse configurations were compared between the three fixation groups.
Results: The stiffness was statistically higher in Group K and Group C compared to Group B in both axial and transverse loading. Similarly, the maximum load was significantly higher in both Group K and Group C compared to Group B in both loading conditions. No significant difference was found between Group K and Group C in stability. The higher failure strength was obtained with headless compression screws (113.34±35.88 N) in the axial loading. The lowest failure strength was found in the absorbable pins technique (16.17±7.72 N) in the transverse loading.
Conclusion: No significant difference was found between the Kirschner wires and headless compression screws techniques, although the highest strength was obtained with headless compression screws that are increasingly used in orthopedic practice.
Background:
Sesamoid bones and accessory ossicles of the foot and ankle, although mostly asymptomatic, can be sources of pain or degenerative changes in response to overuse and trauma. We investigated the prevalence of accessory ossicles and sesamoid bones in a population of Italian women with hallux valgus.
Methods:
A single-center study was performed to determine the prevalence of accessory ossicles and sesamoid bones in the ankle and foot. A total of 505 women with hallux valgus aged 26 to 80 years at the time of hallux valgus correction were examined. Anteroposterior, oblique, lateral foot radiographs and a Muller view were examined regarding the presence, prevalence, coexistence, and distribution of accessory ossicles and sesamoid bones in both feet. The radiographs were analyzed independently by three experienced specialists in foot and ankle surgery. Disagreements were discussed in a consensus meeting, where the radiographs were reevaluated and a final decision was made.
Results:
There was no statistically significant difference between data of the accessory ossicles and sesamoid bones according to the χ2 test. Sesamoid bones were detected in 404 of the 505 patients. The fifth metatarsal sesamoid bone was found in 97 patients. All of the patients presented hallucal sesamoid bones.
Conclusions:
This is the first detailed report of the prevalence of accessory ossicles and sesamoid bones of the feet in Italian women with hallux valgus. These findings could help clinicians in the diagnosis and management of disorders of accessory ossicles and sesamoid bones, which are often undiagnosed, painful foot syndromes. (J Am Podiatr Med Assoc 103(3): 208–212, 2013)
