Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “HALLUX VALGUS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources
PubMedDate not supplied

Effect on balance and gait secondary to removal of the second toe for digital reconstruction: 5-year follow-up.

Foot anatomy and lower limb function were analyzed in 11 children (aged 6.5-12.5 y) 5 years after removal of one or two second toes for digital reconstruction. In addition to physical examination and x-rays, postural balance and three-dimensional measurements of gait were analyzed. Among the 15 operated feet, five had bridle scars, three had claw deformities of the third toe, five had pain in the first intermetatarsal space, and seven had overt or early-stage hallux valgus (including five after unilateral toe removal). Hallux valgus deformation was also observed in three nonoperated feet. Maintenance of balance and rate of displacement of the center of pressure when standing on one foot with eyes closed were significantly altered for operated limbs compared with nonoperated limbs. Gait was rapid because of increased step cadence. Foot progression angle and ankle and knee joint sagittal kinematics during walking were normal. Although children appeared to not be affected in their daily life by the removal of the second toe(s), related foot anatomic and functional modifications require further follow-up.

Amputation, Surgical↗
PubMedDate not supplied

The modified McBride procedure: clinical, radiological, and pedobarographic evaluations.

Nineteen patients (27 feet) with symptomatic hallux valgus who underwent modified McBride procedure were studied prospectively. The outcome measures included preoperative and postoperative American Orthopaedic Foot and Ankle Society's Hallux Metatarsophalangeal-Interphalangeal scoring, weight-bearing radiographs, and pedobarography using the EMED-SF*6 System. The average patient age was 49.7 years, and all patients were women. The average follow-up was 7 months. Results showed an average improvement in rating scale score from 53 to 87/100, in the hallux valgus angle from 32 degrees to 15 degrees, and in the first intermetatarsal angle from 15 degrees to 10 degrees. Pedobarographic analysis showed a statistically significant increase in the contact area of the hallux by 17.5% (P<.001), with a reduction of peak pressures of the hallux by 29% from 67.5+/-29.5 N/cm2 to 48+/-34 N/cm2 (P<.001; confidence interval, 9.887, 29.233) and the total foot by 8% from 89+/-26 N/cm2 to 82+/-25 N/cm2 (P<.05; CI, 0.727, 14.900). The overall satisfaction rate was 96%. We conclude that the modified McBride procedure has a role in patients with passively correctable hallux valgus and a supple metatarsocuneiform joint.

Adult↗
PubMed2005

Proximal crescentic metatarsal osteotomy: the effect of saw blade orientation on first ray elevation.

BACKGROUND: Moderate and severe hallux valgus deformities generally require a proximal metatarsal osteotomy to correct a widened intermetatarsal angle. Although excellent results have been reported using the proximal crescentic osteotomy, concerns have been raised about the incidence of postoperative dorsal malunion, which may lead to transfer lesions. The objectives of this paper were to evaluate the influence of saw blade angulation on the final position of the first metatarsal and to test a new technique used to ensure proper orientation of the osteotomy. METHODS: For part I of the study, 26 Sawbones specimens with hallux valgus deformities were corrected using a proximal crescentic osteotomy with the saw blade position incrementally rotated in the coronal plane. The sagittal change in the final position of the metatarsal was quantified radiographically and correlated to the saw blade orientation. For part II of the study, a Kirschner wire was placed in a vertical position into the medial cuneiform to serve as a guide for the crescentic saw blade in 13 cadaver feet with hallux valgus. Metatarsus primus elevatus was measured after surgical correction. RESULTS: Part I of the study demonstrated a highly linear relationship (R2=0.95) between first metatarsal elevation and the orientation of the saw blade. Every 10-degree of saw blade angulation resulted in a 2-mm change in the sagittal position of the first metatarsal. In part II of the study, the average change in metatarsus primus elevation for the 13 specimens after surgical correction of the hallux valgus deformity was only 1.1 mm (range -3.9 to +4.9 mm). Eleven of the 13 specimens had less than 2.5 mm of elevatus. CONCLUSION: Dorsal malunion of the first metatarsal after proximal crescentic osteotomy is a recognized complication. The final position of the hallux metatarsal is influenced by the coronal plane orientation of the saw. A new technique is described to aid the surgeon in proper alignment of the saw and help prevent excessive first ray elevation.

Cadaver↗
PubMed1991

Chevron osteotomy fixed with absorbable polyglycolide pins.

Seventy-eight chevron osteotomies augmented by internal fixation with self-reinforced polyglycolide pins, 2 mm in diameter, were performed in 60 patients suffering from a painful hallux valgus. The mean metatarsophalangeal angle was 31 degrees, and there was a metatarsus primus varus varying from 10 degrees to 20 degrees. The average follow-up time was 14 (range, 12 to 31) months. No postoperative redisplacement or disturbance of healing of the osteotomy was observed, but recurrence of hallux valgus occurred in 8 feet (10%), each initially with a moderate to severe hallux valgus. Some pain at the first metatarsophalangeal joint during physical activity remained in 12 feet (15%). There was a mean shortening of 2.5 mm of the first metatarsal bone, and the most significant shortening was associated with pain in the forefoot. The metatarsophalangeal joint motion was not decreased. The subjective overall result was excellent or good in 75% of the patients. Because of the biodegradability of the implants used, no secondary procedures to remove the implants were necessary.

Adolescent↗
PubMed1992

Great toe metatarsophalangeal joint arthrodesis: a user-friendly technique.

Thirty-four feet (23 patients) were treated with a metatarsophalangeal (MP) joint fusion of the hallux using five threaded 0.062-in K wires for fixation. Operations were done for the following diagnoses: rheumatoid arthritis (26 procedures), hallux rigidus (1), salvage of previous bunionectomies (3), hallux valgus with absent toe, bilateral fusion (2), severe hallux valgus with chronic MP joint synovitis (1), and congenital hallux varus (1). The ages ranged from 17 to 73 years, with an average of 55 years. Follow-up was available on 31 of the fusions by questionnaire and telephone contact, with an average follow-up of 24 months and a minimum of 1 year. The successful arthrodesis rate was 97%. In 9% of the procedures (three cases), the patients were dissatisfied: This was due to pain under the first metatarsal head in two cases and to impingement between the first and second toes in a third case. In 91% of the fusions (29 of 32 patient responses), the patients stated that they would have the surgery if they had to choose again. Patients indicated "complete satisfaction" in 15 fusions and "satisfaction with reservations" in 14. Patients felt that their ability to wear desired shoes was improved in 48% of the procedures, was unchanged by the fusions in 26%, and was worse than before the operation in 26%. Based on this study and review of the literature, a recommendation is made for fusing the rheumatoid hallux with 25 degrees to 30 degrees of valgus and 10 degrees of extension. In general, selection of toe position for fusion is based on reducing stress on the hallux interphalangeal joint and accommodating the position of the second toe. The multiple pin fixation technique gives a high incidence of fusion, it is easy to perform, and it is adaptable to the varying requirements for toe position.

Adolescent↗
PubMedDate not supplied

Relationship between foot type, foot deformity, and ulcer occurrence in the high-risk diabetic foot.

We hypothesized an association between foot type, foot deformity, and foot ulceration and conducted an analysis of a well-characterized, high-risk diabetic population of 398 subjects. The average age was 62 years of age and 74% of the study population were males. Foot-type distributions were 19.5% pes cavus (high arch), 51.5% neutrally aligned (normal arch), and 29.0% pes planus (low arch). We quantified the presence of hallux valgus (23.9%), hammer/claw toes (46.7%), and hallux limitus (24.4%). A significant association was found between foot type and hallux valgus (p = 0.003); pes planus feet had the highest prevalence as compared with neutrally aligned feet (odds ratio [OR] = 2.43, p = 0.0006). Foot type was also significantly associated with fixed hammer/claw toes (p = 0.01); pes cavus feet had the highest prevalence as compared with neutrally aligned feet (OR = 3.89, p = 0.001). Foot type was also significantly associated with hallux limitus (p = 0.006) with pes planus feet having the highest prevalence as compared with neutrally aligned feet (OR = 2.19, p = 0.003). However, foot type was not significantly related to any ulcer outcome (p = 0.7). Fixed hammer/claw toes (OR = 3.91, p = 0.003) and hallux limitus (OR = 3.02, p = 0.006) were associated with increased risk of any ulcer occurrence. This study affirms that foot type and foot deformity are related and that foot deformities are associated with ulcer occurrence.

Age Distribution↗
PubMed1998

[Radiographic analysis of the orientation of the distal articular surface of the first metatarsal in the horizontal plane].

PURPOSE OF THE STUDY: The lateral obliquity of the distal metatarsal articular surface is a predominant anatomical factor in hallux valgus pathology. It is important to know its normal angular value. MATERIAL-METHODS: The study included 105 feet without any pathology (48 females and 57 males; 53 left and 52 right between 15 and 72 year old). Weight-bearing, anteroposterior X-rays of the foot was made. We measured the distal metatarsal articular angulation (DMAA), the intermetatarsal angle, the metatarsophalangeal angle, the obliquity of the metatarsocuneiform joint and the length of the first and second metatarsal, and the length of the hallux. RESULTS: The main value of the DMAA was 5.78 degrees in our study, 6.79 degrees for women and 4.92 degrees for men. There was no difference between left and right side, no correlation between intermetatarsal angle and DMAA, neither between biometrics parameters and DMAA. DISCUSSION: Our results confirm the Richardson study on cadaver with a main value of 6 degrees for the DMAA. The DMAA value increases in women and it does not increase proportionaly to the intermetatarsal angle; it increases with the value of the metatarsophalangeal angle. All these points have to be taken in consideration in hallux valgus evaluation. CONCLUSION: The distal metatarsal articular surface has a lateral obliquity of 5.78 degrees. It must be evaluated before surgical correction of hallux valgus, in order to decrease recurrence rate of this pathology and iatrogenic deformity.

Adolescent↗
PubMed1996

Radiographic assessment of the second metatarsal: measure of first ray hypermobility.

Hypermobility of the first metatarsal cuneiform joint has been implicated as a cause of the hallux valgus deformity. The objective definition of hypermobility at this joint, however, has not been clearly defined. We used a modified Coleman block test to accentuate motion at the first metatarsal cuneiform joint in order to measure physiologic limits of motion in vivo. This motion was compared with radiographic analysis of the feet, which included the hallux valgus angle, intermetatarsal angle, and medial cortical thickening at the midshaft of the second metatarsal. This assessment was performed on 100 feet (50 right feet and 50 left feet in 50 patients). The average intermetatarsal angle was 8.7 degrees (range, 4-14 degrees), the average hallux valgus angle was 11 degrees (range, 4 degrees of varus to 30 degrees of valgus), and the average midshaft medial cortical thickness was 3.2 mm (range, 2.0-5.5 mm). Pearson's correlation coefficient was calculated to compare these factors. The relationship between variables was found to be small (r < or = 0.2). Motion was noted to occur in the normal foot at this joint and a range of normal values for medial cortical thickness was identified.

Adult↗
PubMed1987

The pathophysiology of the juvenile bunion.

While the surgeon may tend to use one procedure in the repair of a hallux valgus deformity, versatility is most important when treating the juvenile bunion. Using a distal soft-tissue repair when subluxation is solely at the metatarsophalangeal joint is an acceptable approach. A metatarsal or cuneiform osteotomy is necessary if the intermetatarsal angle is abnormally large. It is important not to stretch the indications for a bunion technique in order to correct the hallux valgus deformity. If a more severe deformity is present, a more aggressive technique must be used to correct the abnormality. That varying success rates are reported with different techniques testifies to the fact that the juvenile bunion is not suited for a standard hallux valgus repair. The surgical technique used to repair a specific juvenile bunion depends upon the anatomic and physiologic abnormalities present in each patient.

Adolescent↗