• 1. 

    Coughlin MJ: Hallux valgus. Instr Course Lect 46: 357, 1997.

  • 2. 

    Mann RA: Decision-making in bunion surgery. Iowa Orthop J 10: 110, 1990.

  • 3. 

    Smith RW, Reynolds JC & Stewart MJ: Hallux valgus assessment: report of the research committee of the American Orthopedic Foot and Ankle Society. Foot Ankle 5: 92, 1984.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4. 

    Southerland JT: McGlamry's Comprehensive Textbook of Foot and Ankle Surgery, Vol 1, p 609, 4th ed, Lippincott William s& Wilkins, Philadelphia, 2013.

    • Search Google Scholar
    • Export Citation
  • 5. 

    Perera AM, Mason L & Stephens MM: The pathogenesis of hallux valgus. J Bone Joint Surg Am 93: 1650, 2011.

  • 6. 

    Myerson MS & Badekas A: Hypermobility of the first ray. Foot Ankle Clin 5: 469, 2000.

  • 7. 

    Dufour AB, Casey VA & Golightly YM et al.: Characteristics associated with hallux valgus in a population-based foot study of older adults. Arthritis Care Res 66: 1880, 2014.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. 

    Kato S & Watanabe S: The etiology of hallux valgus in Japan. Clin Orthop Relat Res 157: 78, 1981.

  • 9. 

    Dunn JE, Link CL & Felson DT et al.: Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol 159: 491, 2004.

  • 10. 

    Roddy E, Zhang W & Doherty M: Prevalence and associations of hallux valgus in a primary care population. Arthritis Rheum 59: 857, 2008.

  • 11. 

    Coughlin MJ & Jones CP: Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int 28: 759, 2007.

  • 12. 

    Mann RA, Rudicel S & Graves SC: Repair of hallux valgus with a distal soft tissue procedure and proximal metatarsal osteotomy: a long term follow up. J Bone Joint Surg Am 74: 124, 1992.

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

    Coughlin MJ, Saltzman CL & Nunley JA 2nd: Angular measurements in the evaluation of hallux valgus deformities: a report of the ad hoc committee of the American Orthopaedic Foot & Ankle Society on angular measurements. Foot Ankle Int 23: 68, 2002.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. 

    Schneider W & Knahr K: Metatarsophalangeal and intermetatarsal angle: different values and interpretation of postoperative results dependent on the technique of measurement. Foot Ankle Int 19: 532, 1998.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15. 

    Kılıçoğlu O: Diseases of the great toe: Hallux valgus and hallux rigidus. TOTBID Dergisi 12: 390, 2013.

  • 16. 

    Justin J, Ray MD & Andrew J: Hallux valgus. Foot and Ankle Ortopaedics 4: 1, 2019.

  • 17. 

    Coughlin MJ, Mann RA & Saltzman CL: Surgery of the Foot and Ankle, Vol 1, p 183, 8th ed, Mosby Elsevier, Philadelphia, 2007.

  • 18. 

    Karasick D & Wapner KL: Hallux valgus deformity: preoperative radiologic assessment. AJR Am J Roentgenol 155: 119, 1990.

  • 19. 

    Jones S, Al Hussainy HA & Ali F et al.: Scarf osteotomy for hallux valgus. A prospective clinical and pedobarographic study. J. Bone Joint Surg Br 86: 830, 2004.

  • 20. 

    Kilmartin TE, Barrington RL & Wallace WA: Metatarsus primus varus. J. Bone Joint Surg Br 73: 937, 1991.

  • 21. 

    Coetzee JC & Wickum D: The Lapidus procedure: a prospective cohort outcome study. Foot Ankle Int 25: 526, 2004.

  • 22. 

    Daghino W, Milano L & Ronco S: A comparison between the Regnauld arthroplasty and osteotomies of the first ray for the treatment of hallux valgus. J Foot Ankle Surg 42: 155, 2003.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23. 

    Gould JS, Ali S & Fowler R et al.: Anchor enhanced capsulorraphy in bunionectomies using an L-shaped capsulotomy. Foot Ankle Int 24: 61, 2003.

  • 24. 

    Lombardi CM, Silhanek AD & Connolly FG et al.: First metatarsocuneiform arthrodesis and Reverdin-Laird osteotomy for treatment of hallux valgus: an intermediate-term retrospective outcomes study. J Foot Ankle Surg 42: 77, 2003.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25. 

    Nery C, Barroco R & Ressio C: Biplanar chevron osteotomy. Foot Ankle Int 23: 792, 2002.

  • 26. 

    Rink-Brüne O: Lapidus arthrodesis for management of hallux valgus – a retrospective review of 106 cases. J Foot Ankle Surg 43: 290, 2004.

  • 27. 

    Schneider W, Aigner N & Pinggera O et al.: Chevron osteotomy in hallux valgus. Ten-year results of 112 cases. J Bone Joint Surg 86: 1016, 2004.

  • 28. 

    Coughlin MJ, Freund E: & Roger A. Mann Award. The reliability of angular measurements in hallux valgus deformities. Foot Ankle Int 22: 369, 2001.

  • 29. 

    Lee KM, Ahn S & Chung CY et al.: Reliability and relationship of radiographic measurements in hallux valgus. Clin Orthop Relat Res 470: 2613, 2012.

  • 30. 

    van der Woude P, Keizer SB & Wever-Korevaar M et al.: Intra- and interobserver agreement in hallux valgus angle measurements on weightbearing and non-weightbearing radiographs. J Foot Ankle Surg 58: 706, 2019.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31. 

    Sung H, Lee KT & Young KW et al.: Dilemma in severity classification of incongrent hallux valgus deformity using radiological measurements. J Korean Orthop Assoc 40: 549, 2005.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32. 

    Cho NH, Kim S & Kwon DJ et al.: The prevalence of hallux valgus and its association with foot pain and function in a rural Korean community. J Bone Joint Surg Br 91: 494, 2009.

    • Search Google Scholar
    • Export Citation
  • 33. 

    Fraissler L, Konrads C & Hoberg M et al.: Treatment of hallux valgus deformity. EFORT Open Rev 1: 295, 2016.

  • 34. 

    Hecht PJ & Lin TJ: Hallux valgus. Med Clin North Am 98: 227, 2014.

Relationship of Dome Height of the First Metatarsal Head with Hallux Valgus Angle and Metatarsophalangeal Alignment

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Objectives

Hallux valgus (HV) is a progressive foot deformity in which the first metatarsophalangeal (MTP) joint is affected. The relationship between the dome height of the first metatarsal head and the HV deformity has not been studied previously. This study aimed to investigate a possible relation of the dome height of the first metatarsal head with articular alignment and the hallux valgus angle (HVA), which is frequently used to evaluate HV.

Methods

A total of 129 feet of 68 patients were included in the study. Anteroposterior digital radiographic images of the foot taken in a weightbearing, standing position were used to assess the HVA, dome height, and shape of the first metatarsal head and the alignment of the MTP joint. The dome height of the first metatarsal head is the vertical distance from the base to the highest point of the articular surface doming. The alignment was categorized into three groups: aligned, deviated, and subluxated. Patients were assigned into three groups based on the HVA: Normal, Mild HV and Moderate HV.

Results

A statistically significant, positive correlation was found between the HVA and the dome height of the first metatarsal head (r = 0.293, P = 0.001 and P < 0.05). The dome height was significantly lower in the patients with a normal HVA than those with a high HVA (P 1 = 0.042, P 2 = 0.039 and P < 0.05, respectively). The dome height of the first metatarsal head was found significantly higher in feet with subluxation, compared to feet aligned and deviated (P 1 = 0.001; P 2 = 0.0089 and P < 0.05, respectively).

Conclusions

Our study results suggest that HV deformity may be related to an increased dome height and the measurement of the dome height of the first metatarsal head might be used to evaluate an anatomic tendency toward HV development.

Department of Radiology, University of Health Sciences, Istanbul Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

Corresponding author: Esin Derin Cicek, MD, Department of Radiology, University of Health Sciences, Istanbul Fatih Sultan Mehmet Training and Research Hospital, E5 karayolu üzeri, Icerenköy mah. Ataşehir, Istanbul, Turkey, 34752. (E-mail: eederin@gmail.com)