ABSTRACT
PURPOSE: With differences between the sexes in foot bone anatomy and ligamentous laxity, there is the possibility that the results of hallux valgus surgery may also differ between the sexes. We aimed to compare the results of hallux valgus surgery between the sexes. MATERIALS AND METHODS: The authors retrospectively reviewed 60 males (66 feet) and 70 females (82 feet) who underwent distal or proximal chevron osteotomy for the treatment of hallux valgus deformity between June 2005 and December 2011. We compared the clinical and radiologic outcomes between the sexes. RESULTS: There were no statistically significant differences in demographics between the sexes. The mean American Orthopedic Foot and Ankle Society score, visual analogue scale for pain, and patient satisfaction at the last follow-up did not differ significantly between the sexes. The mean preoperative hallux valgus angle (HVA) and inter-metatarsal angle (IMA) were not significantly different between the sexes. At the last follow-up, the mean HVA was significantly greater in females (p=0.003) than in males; mean IMA was not significantly different between the sexes. The mean correction of HVA in males was significantly greater than that in females (p=0.014). CONCLUSION: There were no significant differences between the sexes regarding clinical outcomes after distal and proximal chevron osteotomy. However, male patients achieved greater correction of HVA than female patients. There is a possibility that sexual dimorphism of the foot may affect postoperative HVA.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Hallux Valgus/physiopathology , Metatarsal Bones/physiopathology , Osteotomy/methods , Pain , Pain Measurement , Patient Satisfaction , Postoperative Period , Retrospective Studies , Sex Factors , Treatment OutcomeABSTRACT
PURPOSE: With differences between the sexes in foot bone anatomy and ligamentous laxity, there is the possibility that the results of hallux valgus surgery may also differ between the sexes. We aimed to compare the results of hallux valgus surgery between the sexes. MATERIALS AND METHODS: The authors retrospectively reviewed 60 males (66 feet) and 70 females (82 feet) who underwent distal or proximal chevron osteotomy for the treatment of hallux valgus deformity between June 2005 and December 2011. We compared the clinical and radiologic outcomes between the sexes. RESULTS: There were no statistically significant differences in demographics between the sexes. The mean American Orthopedic Foot and Ankle Society score, visual analogue scale for pain, and patient satisfaction at the last follow-up did not differ significantly between the sexes. The mean preoperative hallux valgus angle (HVA) and inter-metatarsal angle (IMA) were not significantly different between the sexes. At the last follow-up, the mean HVA was significantly greater in females (p=0.003) than in males; mean IMA was not significantly different between the sexes. The mean correction of HVA in males was significantly greater than that in females (p=0.014). CONCLUSION: There were no significant differences between the sexes regarding clinical outcomes after distal and proximal chevron osteotomy. However, male patients achieved greater correction of HVA than female patients. There is a possibility that sexual dimorphism of the foot may affect postoperative HVA.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Hallux Valgus/physiopathology , Metatarsal Bones/physiopathology , Osteotomy/methods , Pain , Pain Measurement , Patient Satisfaction , Postoperative Period , Retrospective Studies , Sex Factors , Treatment OutcomeABSTRACT
Evaluar los resultados clínicos y radiográficos de la osteotomía en Scarf para el tratamiento del hallux valgas moderado-severo. Material y métodos: Realizamos un estudio retrospectivo con 25 osteotomías en Scarf realizadas desde marzo de 2009 a junio de 2011 con un seguimiento medio de 11 meses para el tratamiento del hallux valgus moderado-severo. Se realizó una valoración clínica de forma pre y postoperatoria según la escala funcional de la American Orthopaedic Foot and Ankle Society (AOFAS) y una valoración radiográfica, mediante la medición de los ángulos intermetatarsiano (IMA), de hallux valgus (HVA) y distal de la articulación metatarsofalángica (DMAA), también de forma pre y postoperatoria. Resultados: En el estudio, 19 pacientes fueron mujeres y 6 hombres, siendo la edad media de 45 años. La estancia media de ingreso fue de 1.2 días. Según la escala AOFAS, se obtuvo una puntuación global preoperatoria de 34.44 y postoperatoria de 92.4. En cuanto a los resultados radiológicos postoperatorios, obtuvimos un IMA medio de 8.84° y un HVA medio de 18.2°. El DMAA fue menor de 10° excepto en 1 paciente. Conclusión: La osteotomía en Scarf ofrece al paciente un apoyo temprano, una movilidad metatarso-falángica precoz y una rápida consolidación de la osteotomía. Obtuvimos unos buenos resultados a corto-medio plazo para el tratamiento del hallux valgus moderado-severo(AU)
To assess the clinical and radiographic results of the Scarf osteotomy in the treatment of moderatesevere hallux valgus. Patients and methods: We performed a retrospectiva study of 25 Scarf osteotomies from March 2009 to June 2011 with an average follow up of 11 months for the treatment of the moderate-several hallux valgus. We assessed the clinical outcome pre and postoperative according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale and radiological outcome, with measuring the angles intermetatarsal (IMA), of hallux valgus (HVA) and distal of metatarsal-phalang joint (DMAA), pre and postoperative. Results: In the study, 19 patients were women and 6 men with average age of 45 years. Tbe average stay of revenue was 1.2 days. According to the AOFAS scale, we obtained a global preoperative score of 34.44 and postoperative of 92.4. About the postoperative radiological findings, we obtained an average IMA of 8.84° and HVA of 18.2 °. Ttle DMAA was less than 10° except in 1 patient. Conclu ion: The Scarf osteotomy offers an early load, an early metatarsal-phalang joint mobility and an early osteotomy consolidation. We performed a good results in the short-medium term for the treatment of the moderate-severe hallux valgus(AU)
Subject(s)
Humans , Male , Female , Adult , Osteotomy , Hallux Valgus/physiopathology , Orthopedic Procedures , Toe Phalanges/surgery , Foot , Ankle , Metatarsophalangeal JointABSTRACT
OBJETIVO: Este trabalho teve como objetivo estimar as forças plantares nos dedos dos pés de mulheres com hálux valgo e/ou pés planos. MÉTODOS: Trata-se de um estudo transversal envolvendo mulheres com hálux valgo e/ou pés planos confirmado através de análise radiográfica. Mediram-se as forças plantares, utilizando plataformas de forças. Coletaram-se estas forças com as mulheres descalças e em posição ereta, por três medidas sendo obtida uma média. Os dados foram adquiridos através da ponte amplificadora Spider 8 da HBM e analisados através do programa Catman®. Obtiveram-se as medidas de forças dos dedos de ambos os pés e as médias foram comparadas pelo teste t de Student segundo a presença de hálux valgo e pés planos; a associação entre essas deformidades foi estimada pelo teste exato de Fischer bicaudal, a significância estatística adotada foi alfa = 5 por cento. RESULTADOS: Foram incluídas no estudo, vinte mulheres com presença ou não de hálux valgo. As forças médias encontradas mostraram-se maiores no 5º dedo em relação ao 1º dedo de ambos os pés (p< 0,05) em ambas as situações. CONCLUSÃO: Neste estudo encontraram-se, ao contrário de outros trabalhos, forças no 5º dedo maiores que no 1º em ambos os pés.
OBJECTIVE: to measure the plantar forces above the toes of women with hallux valgus and/or flat feet. METHODS: This study involved women with hallux valgus and/or flat feet confirmed by X-ray images. The plantar forces were measured utilizing force plates. Force was measured three times, which were taken with the women on barefoot and at upright position, recording the average for the three measurements. Data were acquired from Spider 8 system (HBM) and analyzed by using a Catman® software. The measurements for both feet's toes force were reported and the averages were compared by the Student's t-test according to the presence of hallux valgus and flat feet; the association between these deformities was estimated by using the two-tailed Fischer's exact test, the statistical significance adopted was alpha = 5 percent. RESULTS: For this study, 20 women with or without hallux valgus were included. The mean force values found showed to be higher on the fifth toe compared to first toe of both feet (p < 0.05) in both situations. CONCLUSION: in this study, we found strong forces on the fifth toe than on the first toe, contradicting some studies in literature.
Subject(s)
Humans , Female , Young Adult , Middle Aged , Hallux Valgus/physiopathology , Flatfoot/physiopathology , Flatfoot , Body Mass Index , Brazil , Cross-Sectional StudiesABSTRACT
Os autores estudam a deformidade conhecida por joanete, que frequentemente se acompanha pelo chamado dedo em "martelo" de um ou mais dos outros artelhos. Fazem um estudo crítico da etiofisiopatogenia do joanete, mostrando a maior incidência na raça branca e ausência quase total nos aborígenes que vivem descalços. Realçam a importância dos sapatos de salto alto e bico fino na etiologia do joanete. Indicam como cirurgia eletiva a técnica do Hueter-Mayo(11), pela sua simplicidade e bons resultados
Subject(s)
Humans , Female , Hallux Valgus/physiopathology , Hallux Valgus/etiologyABSTRACT
Nuestro trabajo comenzo en el año 1976, con el ingreso al Servicio de Ortopedia y Traumatologia de Institutos Medicos Antartida. Hemos confeccionado un protocolo terapeutico para el tratamiento de las afecciones ortopedicas mas frecuentes del antepie humano: hallux valgus, con o sin metatarso primo varo, metatarsalgia, dedos en garra y juanetillo de sastre. El tratamiento se basa en suprimir el dolor, corregir la estetica y preservar la funcion. Hacemos una reseña antropologica del desarrollo del antepie, describimos en forma breve la anatomia podalica de las zonas topograficas a tratar. Explicamos la fisiopatologia del hallux valgus, del juanetillo, de la metatarsalgia y de la garra digital podalica. Mostramos las distintas tecnicas que utilizamos y por que preferimos cada una de ellas, fundamentalmente nuestras preferencias con bases anatomofisiopatologicas (resumen truncado)