Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 480
Filter
1.
Gait Posture ; 111: 156-161, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38703444

ABSTRACT

BACKGROUND: Hallux valgus is a common condition where the subluxation of the first metatarsophalangeal joint and lateral deviation of the hallux at the interphalangeal joint creates difficulty with footwear fit. Footwear and foot orthoses are commonly prescribed nonsurgical treatments for hallux valgus. RESEARCH QUESTION: Do extra-width footwear and foot orthoses influence peak pressure at the medial aspect of the metatarsophalangeal and interphalangeal joints in women with hallux valgus? METHODS: Community-dwelling women with symptomatic hallux valgus underwent gait testing when wearing their own shoes and when wearing extra-width footwear fitted with three-quarter length, arch-contouring prefabricated foot orthoses. Peak pressure (kPa) on the medial aspect of the metatarsophalangeal and medial interphalangeal joints and on the plantar surface of the foot (hallux, lesser toes, metatarsophalangeal joint 1, metatarsophalangeal joints 2-5, midfoot and heel) were measured using the novel pedar®-X system with the pedar® pad and pedar® insole, respectively (Novel, GmbH, Munich, Germany). Paired samples t-tests were used to calculate the differences between the two conditions, and the magnitude of observed differences was calculated using Cohen's d. RESULTS: We tested 28 participants (aged 44-80 years, mean 60.7, standard deviation 10.7). Compared to their own footwear, wearing the intervention footwear and orthoses was associated with a statistically significant decrease in pressure on the medial aspect of the metatarsophalangeal joint (58.3 ± 32.8 versus 42.6 ± 32.8, p=0.026, d=0.49), increased pressure under the midfoot (70.7 ± 25.7 versus 78.7 ± 23.6, p=0.029, d=0.33) and decreased pressure underneath the heel (137.3 ± 39.0 versus 121.3 ± 34.8, p=0.019, d=0.45). SIGNIFICANCE: The intervention footwear and orthoses significantly decreased peak pressure on the medial aspect of the first metatarsophalangeal joint but had no significant effect on the interphalangeal joint. Further studies are required to determine whether these changes are associated with improvements in symptoms associated with hallux valgus.


Subject(s)
Foot Orthoses , Hallux Valgus , Metatarsophalangeal Joint , Pressure , Shoes , Humans , Female , Metatarsophalangeal Joint/physiopathology , Middle Aged , Hallux Valgus/rehabilitation , Hallux Valgus/physiopathology , Hallux Valgus/therapy , Aged , Adult
2.
J Med Ultrason (2001) ; 51(2): 331-339, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38546904

ABSTRACT

PURPOSE: To quantify the vertical translation between the first metatarsal and medial cuneiform during the stance phase of gait in young individuals with and without hallux valgus. DESIGN: This cross-sectional observational study included 34 young adults (male, n = 4; female, n = 30) who were divided into three groups according to the hallux valgus angle: control (< 20°, n = 13), mild hallux valgus (≥ 20° to < 30°, n = 12), and moderate hallux valgus (≥ 30°, n = 9). The mobility of the first tarsometatarsal joint was evaluated during the stance phase using B-mode ultrasound synchronized with a motion analysis system. RESULTS: The medial cuneiform shifted more plantar during the early phase in mild hallux valgus and during the middle and terminal phases in moderate hallux valgus than in control. The severity of the hallux valgus was correlated with a trend toward plantar shift of the medial cuneiform. The first metatarsal was located more dorsal than the medial cuneiform; however, there was no significant variation. No significant differences in the peak ankle plantarflexion angle and moment were noted between the groups. CONCLUSION: The hypermobility of the first tarsometatarsal joint, especially plantar displacement of the medial cuneiform in the sagittal plane, was found in young individuals with hallux valgus during the stance phase of gait, and the mobility increased with the severity of hallux valgus. Our findings suggest the significance of preventing hallux valgus deformity early in life.


Subject(s)
Gait , Hallux Valgus , Ultrasonography , Humans , Hallux Valgus/diagnostic imaging , Hallux Valgus/physiopathology , Female , Male , Cross-Sectional Studies , Ultrasonography/methods , Gait/physiology , Young Adult , Adult , Metatarsal Bones/diagnostic imaging , Metatarsal Bones/physiopathology , Range of Motion, Articular , Imaging, Three-Dimensional/methods , Tarsal Joints/diagnostic imaging , Tarsal Joints/physiopathology , Motion Capture
3.
Foot Ankle Int ; 45(5): 485-495, 2024 May.
Article in English | MEDLINE | ID: mdl-38348624

ABSTRACT

BACKGROUND: This study examines the correction of lesser toe valgus deviation following proximal chevron metatarsal osteotomy (PCMO) and Akin osteotomy in moderate to severe hallux valgus patients, while identifying influencing factors. METHOD: Among 89 patients (116 feet), those with moderate to severe hallux valgus underwent PCMO and Akin osteotomy. Radiologic assessments included preoperative metatarsus adductus angle (MAA), hallux valgus angle (HVA), intermetatarsal angle (IMA), valgus angles of the second to fourth metatarsophalangeal joints, and hallux valgus recurrence. Assessments included visual analog scale (VAS) pain scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, and patient satisfaction over an average follow-up of 30.6 ± 21.2 (range, 12-99) months. RESULTS: The mean preoperative HVA of 34.4 degrees decreased to 8.7 degrees at final follow-up. The valgus angles of the second, third, and fourth toes improved by 37.1%, 27%, and 44.5%, respectively. In metatarsus adductus patients, lesser toe valgus angles were significantly higher both preoperatively and at final follow-up. Hallux valgus recurrence patients had higher preoperative and final follow-up IMA and valgus angles in the second and third toes. Nonrecurrence patients showed greater decreases in these angles. A larger HVA correction corresponded to a greater decrease in lesser toe valgus deviation. VAS and AOFAS scores improved significantly at the last follow-up. CONCLUSION: The study found a significant reduction in the valgus angle of the second, third, and fourth toes after PCMO and Akin osteotomy in moderate to severe hallux valgus cases, without additional surgeries on lesser toes. The lesser toe angular reductions were less pronounced in patients with metatarsus adductus or with hallux valgus recurrence. LEVEL OF EVIDENCE: Level IV, case series.


Subject(s)
Hallux Valgus , Metatarsal Bones , Osteotomy , Humans , Hallux Valgus/surgery , Hallux Valgus/diagnostic imaging , Hallux Valgus/physiopathology , Osteotomy/methods , Metatarsal Bones/surgery , Metatarsal Bones/diagnostic imaging , Female , Male , Middle Aged , Adult , Radiography , Retrospective Studies , Aged , Patient Satisfaction , Metatarsophalangeal Joint/surgery , Metatarsophalangeal Joint/physiopathology , Metatarsophalangeal Joint/diagnostic imaging , Toes/surgery , Pain Measurement
4.
Rev. esp. podol ; 34(2): 90-98, 2023. ilus, tab, graf
Article in Spanish, English | IBECS | ID: ibc-229376

ABSTRACT

Objetivos: Analizar las diferencias de lateralidad en el movimiento de rotación y torsión en la extremidad inferior y su posible influencia en el desarrollo del hallux abductus valgus.Pacientes y métodos: La muestra incluyó 129 mujeres. Se evaluó el grado de severidad del hallux abductus valgus, la rotación de cadera, la torsión tibial, la movilidad de la primera articulación metatarsofalángica, el índice postural del pie y el ángulo de progresión del pie. Resultados: Nuestros resultados mostraron que existían diferencias en la rotación externa entre ambas caderas de 2.34° (p < 0.001) y entre la rotación interna y externa de la cadera izquierda de 4.11° (p < 0.002). También se encontró una diferencia del ángulo de progresión del pie de 3° (p < 0.001), pero no hubo diferencias significativas entre la torsión tibial y el índice postural del pie (p > 0.05). Se encontró una diferencia en el rango de movimiento entre ambas primeras articulaciones metatarsofalángicas de 6.30° (p < 0.001), y se halló una relación entre la extensión y el rango de movimiento de la primera articulación metatarsofalángica y el hallux abductus valgus (p < 0.05). Conclusiones: En base a los resultados obtenidos en esta muestra, los datos apuntan a un mayor rango de movimiento de la primera articulación metatarsofalángica en el pie izquierdo. Los resultados también indican un probable predominio de rotación interna de la extremidad izquierda y de rotación externa de la extremidad derecha, que no mostraron asociación con el estadio del hallux abductus valgus en este estudio (AU)


Objectives: To analyze differences in laterality in rotational and torsional movement in the lower extremity and its possible influence on the development of hallux abductus valgus. Patients and methods: The sample included 129 women. The degree of severity of hallux abductus valgus, hip rotation, tibial torsion, mobility of the first metatarsophalangeal joint, foot posture index, and foot progression angle were evaluated. Results: Our results showed that there were differences in external rotation between both hips of 2.34° (p < 0.001) and between internal and external rotation of the left hip of 4.11° (p < 0.002). We also found a difference of the foot progression angle between feet of 3° (p < 0.001), but there was no significant difference between tibial torsion and foot posture index (p > 0.05). A difference in range of motion was found between both first metatarsophalangeal joints of 6.30° (p < 0.001), and a relationship was found between extension and range of motion of the first metatarsophalangeal joint and hallux abductus valgus (p < 0.05). Conclusions: Based on the results obtained in this sample, the data points to a greater range of motion of the first metatarsophalangeal joint in the left foot. The results also indicate a probable predominance of internal rotation of the left extremity and external rotation of the right extremity, which did not show asociation with the degree of hallux aductus valgus in this study (AU)


Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Hallux Valgus/physiopathology , Lower Extremity/physiopathology , Posture/physiology , Severity of Illness Index
5.
J Foot Ankle Res ; 14(1): 17, 2021 Mar 12.
Article in English | MEDLINE | ID: mdl-33712068

ABSTRACT

BACKGROUND: Hallux valgus, lesser toe deformity, and muscle weakness of the toe flexors contribute to falls in older people. This study aimed to examine the differences in toe flexor strength and foot morphology in older people requiring long-term care due to changes in the way they mobilize in everyday life. METHODS: This study included 84 people aged ≥70 years without motor paralysis who underwent rehabilitation. They were divided into those who could mobilize without a wheelchair (walking group, n = 54) and those who used a wheelchair to mobilize (wheelchair group, n = 30). The presence or absence of diseases was confirmed, and hand grip strength, toe flexor strength, and foot morphology using the foot printer were measured. The presence of diseases, hand grip strength, toe flexor strength, and foot morphology were compared between the two groups. Multiple logistic analysis was performed with wheelchair dependence as the dichotomous outcome variable, and the percentages of each strength measure observed in the wheelchair group to the average hand grip and toe flexor strength measures in the walking group were compared. RESULTS: No significant between-group difference in foot morphology was found. The factors related to the differences in ways of ambulating in daily life were history of fracture, heart disease, and toe flexor strength. After comparing the muscle strength of the wheelchair group with the mean values of the walking group, we found that the toe flexor strength was significantly lower than the hand grip strength. CONCLUSIONS: Older people who used a wheelchair to mobilize have significantly less toe flexor strength than those who do not despite no significant difference in foot morphology. Use of a wheelchair is associated with a reduction in toe flexor strength.


Subject(s)
Foot Deformities/physiopathology , Hallux Valgus/physiopathology , Mobility Limitation , Muscle Strength , Walking/physiology , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Foot/physiopathology , Hand Strength , Homes for the Aged , Humans , Logistic Models , Long-Term Care/statistics & numerical data , Male , Toes/physiopathology
6.
J Back Musculoskelet Rehabil ; 34(4): 715-721, 2021.
Article in English | MEDLINE | ID: mdl-33720876

ABSTRACT

BACKGROUND: Hallux valgus, one of the most common foot disorders, contributes to the formation of pain and changes foot biomechanics. OBJECTIVE: To assess the impact of Kinesiology Taping (KT) on foot loading during gait in patients with hallux valgus. METHODS: Forty feet with hallux valgus were examined. Patients wore the KT for a month and the parameters of the foot during gait on a baropodometric platform were measured three times: before taping, immediately after application of taping and after one month's use. RESULTS: The taping had a statistically significant effect on dynamic foot measurements. The maximum and mean foot load (p< 0.001), foot surface (p< 0.001), ratio of forefoot to hindfoot load (p< 0.01) and the proportions of the lateral and medial foot loading (p< 0.05) all changed. During gait cycle, taping significantly increased the load and surface at the first metatarsal head (p< 0.001) while there was a decrease around the second to fifth (p< 0.001) metatarsal heads. CONCLUSIONS: Using KT to correct a hallux valgus is a procedure that has an impact on the dynamic parameters of the foot during gait. The use of this method could become an alternative to surgical treatment for those patients, who have any contraindication for surgery.


Subject(s)
Athletic Tape , Foot/physiopathology , Gait/physiology , Hallux Valgus/physiopathology , Adult , Aged , Biomechanical Phenomena/physiology , Female , Humans , Male , Middle Aged , Treatment Outcome
7.
Qual Life Res ; 30(4): 957-966, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33387287

ABSTRACT

PURPOSE: To estimate the comparative effect of open and percutaneous hallux valgus (HV) surgery on patients' quality of life (QoL) using the American Orthopedic Foot and Ankle Society (AOFAS) scale including total score and individual domains (pain, function, and alignment). METHODS: MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were systematically searched from inception to March 2020 for studies on the effect of HV surgery on patients' QoL using the AOFAS score. A standardized mean difference score was calculated on the total AOFAS score and on each AOFAS domain (pain, function, and alignment) using Cohen's d index. RESULTS: Considering the 53 published studies included, the pooled effect size (ES) estimates for the AOFAS total score were 3.69 (95% CI 3.37-4.01; I2 = 95.5%) for open surgery and 3.40 (95% CI 2.99-3.80, I2 = 88.2%) for percutaneous surgery. The total pooled ES estimate was 3.61 (95% CI 3.35-3.87, I2 = 94.5%). Considering the pain domain, the pooled ES estimates were 2.21 (95% CI 1.98-2.43, I2 = 64%) for open surgery and 2.52 (95% CI 1.83-3.20, I2 = 92.6%) for percutaneous surgery. For the function domain, the pooled ES estimates were 1.37 (95% CI 0.93-1.81, I2 = 91%) for open surgery and 2.28 (95% CI 1.10-3.47, I2 = 96.8%) for percutaneous surgery. Finally, the pooled ES estimates for the alignment domain were 3.99 (95% CI 3.51-4.47, I2 = 85.7%) for open surgery and 2.66 (95% CI 2.23-3.09, I2 = 78.5%) for percutaneous surgery. CONCLUSION: Our data support that HV surgery increases the total AOFAS score as well as the AOFAS scores by domain (pain, function, and alignment). Furthermore, our data show that HV surgery increases patients' QoL, after both open and percutaneous surgery, without differences between them.


Subject(s)
Hallux Valgus/surgery , Quality of Life/psychology , Adolescent , Adult , Aged , Female , Hallux Valgus/physiopathology , Humans , Male , Middle Aged , Treatment Outcome , Young Adult
8.
Foot Ankle Surg ; 27(1): 20-24, 2021 Jan.
Article in English | MEDLINE | ID: mdl-31980384

ABSTRACT

BACKGROUND: Scarf osteotomy has been widely used to restore axial orientation of the first ray in the treatment of hallux valgus deformity. The aim of the study was to present our radiological outcomes of bunion reconstruction, identify surgical complications in early follow-up, and assess to what extent a shortening of the first metatarsal is present after surgery as a possible cause of postoperative metatarsalgia. METHODS: We enrolled 106 patients (118 feet) and assessed patients' pre- and postoperative measurements of hallux valgus and intermetatarsal angles on weightbearing X-ray images. Three different methods of measuring metatarsal length were compared and early postoperative complications noted. RESULTS: Hallux valgus angle decreased significantly by an average of 18.7 degrees and the intermetatarsal angle by 7.8 degrees. Using three methods of measuring metatarsal length, all showed significant shortening of the first metatarsal. Mean relative lengthening of the second metatarsal averaged 0.45mm. The Coughlin method showed the highest interrater reliability (ICC=0.96). CONCLUSIONS: Significant reduction of the hallux valgus angle and intermetatarsal angle was demonstrated with a low complication rate. There was significant shortening of the first metatarsal. The Coughlin method clearly demonstrated an excellent interrater reliability. LEVEL OF EVIDENCE: Level IV.


Subject(s)
Hallux Valgus/surgery , Metatarsal Bones/diagnostic imaging , Osteotomy/methods , Plastic Surgery Procedures/methods , Adolescent , Adult , Aged , Aged, 80 and over , Female , Hallux Valgus/diagnosis , Hallux Valgus/physiopathology , Humans , Male , Metatarsal Bones/surgery , Middle Aged , Radiography , Reproducibility of Results , Treatment Outcome , Weight-Bearing , Young Adult
9.
Clin Biomech (Bristol, Avon) ; 81: 105229, 2021 01.
Article in English | MEDLINE | ID: mdl-33302118

ABSTRACT

BACKGROUND: Investigating the complexity of movement systems can be insightful in clinical decision making. The study conducted to evaluate whether complexity of ground reaction force is affected by hallux valgus grades and footwear or foot side conditions. METHODS: A sample of 120 females including 30 participants in each group of healthy and mild, moderate, and severe hallux valgus were recruited in this case-control study. Hallux valgus grades were assessed using Manchester scale. Ground reaction force were measured in bare foot and shod conditions for both feet and weighted permutation entropy was used to calculate the complexity. Nonparametric tests were employed for statistical inference. FINDINGS: The first important result was that hallux valgus caused loss of complexity of ground reaction force with a medium to large effect size. However, we did not find any difference between three grades of hallux valgus entropy. The second finding was that entropy of healthy group decreased from barefoot to shod condition with a large effect size and the third finding was that ground reaction force entropy were similar in both feet. INTERPRETATION: The findings are aligned with the theory that loss of complexity appears when the biological systems become functionally impaired. As soon as hallux valgus initiates, all potential risks related to the reduction of complexity appear. So, we suggest to administer conservative treatments in the early stages of hallux valgus. The study outcomes can be used for evaluation of foot function, classification of the foot types, or footwear selection.


Subject(s)
Hallux Valgus/physiopathology , Mechanical Phenomena , Movement , Adult , Biomechanical Phenomena , Case-Control Studies , Female , Foot/physiopathology , Humans , Male , Middle Aged , Shoes , Young Adult
10.
Foot Ankle Surg ; 27(4): 395-399, 2021 Jun.
Article in English | MEDLINE | ID: mdl-32624348

ABSTRACT

BACKGROUND: Hallux valgus (HV) is an important risk factor for falls (in older people); however, the detailed relationship is less understood. We aimed to evaluate postural stability in bilateral HV patients. METHODS: Two groups of 20 female patients-an HV group and a C (i.e., non-HV) group-participated in this study. Evaluations were made using the Timed Up and Go (TUG) test, the Berg Balance Scale (BBS), the Falls Efficacy Scale (FES), track length (LNG), velocity (VEL), enveloped area (ENV), and root mean square area (RMS). RESULTS: TUG and FES scores were significantly higher and BBS scores were lower in the HV group than in the C group. LNG was significantly longer, VEL was higher, and ENV and RMS were wider in the HV group than in the C group. CONCLUSIONS: The HV group exhibited impaired walking mobility, balance, and postural stability.


Subject(s)
Accidental Falls , Hallux Valgus/complications , Hallux Valgus/physiopathology , Postural Balance , Walking , Aged , Aged, 80 and over , Case-Control Studies , Fear , Female , Hallux Valgus/psychology , Humans , Middle Aged
11.
Foot (Edinb) ; 45: 101686, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33022578

ABSTRACT

BACKGROUND: Lapidus arthrodesis is an established treatment option for severe hallux valgus deformity especially in patients suffering from instability of the first tarsometatarsal joint. Surgery related metatarsalgia is known to be associated with persistent elevation of the first ray after realignment surgery. Nevertheless, detailed information on ideal positioning of the first ray in Lapidus surgery is missing so far. This study was designed to determine any correlations between radiographic and pedobarographic outcome following the Lapidus procedure with regard to clinical outcome and the occurrence of metatarsalgia. METHODS: Thirty feet (28 patients) after Lapidus surgery were available for follow-up at 42.5±21.0 months. All subjects had radiographic and pedobarographic evaluation of the operated foot and patient satisfaction was recorded using questionnaires. RESULTS: Metatarsalgia was associated with a poorer outcome in FADI and AOFAS scores (p<0.005). A lateral shift of plantar pressure distribution to the third metatarsal head in these cases could be observed. Although Lapidus surgery resulted in significant shortening of the first metatarsal, no correlation to the occurrence of metatarsalgia was detectable. Likewise, axial plane malalignment showed no influence, whereas elevation of the first ray was highly correlated to surgery related metatarsalgia (p=0.007). Subjects suffering from metatarsalgia had a higher BMI (body mass index), but its effect on metatarsalgia turned out not to be significant (p=0.090). CONCLUSION: In Lapidus surgery realignment of the first metatarsal in the sagittal plane seems to be decisive for good clinical outcome. Failing to plantarflex the arthrodesis resulted in a lateral shift of plantar loading with overload of the lesser metatarsals and the occurrence of metatarsalgia.


Subject(s)
Arthrodesis , Hallux Valgus/surgery , Metatarsalgia/epidemiology , Pain, Postoperative/epidemiology , Hallux Valgus/diagnostic imaging , Hallux Valgus/physiopathology , Humans , Metatarsalgia/diagnostic imaging , Pain, Postoperative/diagnostic imaging , Radiography , Retrospective Studies , Treatment Outcome , Weight-Bearing
12.
Foot (Edinb) ; 45: 101689, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33059213

ABSTRACT

BACKGROUND: Little attention has been paid to foot structural factors and ground reaction force in hallux valgus. Investigating the structural factors in detail and determining their biomechanical effects can help to better manage hallux valgus. METHODS: In this case-control study, 120 females, 90 hallux valgus and 30 healthy, were recruited. Hallux valgus grades (mild, moderate, severe), first metatarsal mobility, foot pronation, hallux rotation, and pain were assessed by clinical tests. Ground reaction forces were measured in barefoot and shod conditions for both feet and analyzed using mixed within-between MANOVA. The association between structural factors and pain with force was analyzed using Spearman correlation coefficient. RESULTS: The frequency of foot structural factors and pain severity were reported in hallux valgus grades. A significant difference was seen in the force values between groups (P<0.001). Bonferroni post hoc test indicated that the mean of the first peak for the severe group was significantly higher than the mild group (P=0.013) and the mean of second peak for the moderate group was higher than that of the healthy group (P=0.009). The force values were affected by wearing shoe (P<0.001) but not by foot side (P=0.086). There was a medium, positive correlation between the hallux rotation and force in the moderate group (r=0.39, P=0.03) and also between the pronation and force in the severe group (r=0.36, P=0.04). CONCLUSION: Foot structural factors, pain, and force were different in each hallux valgus grads. Similar force in both feet, and increased force by wearing shoe were seen. The relationship between the pronation and hallux rotation with force revealed the importance of these factors from the biomechanical viewpoint.


Subject(s)
Gait/physiology , Hallux Valgus/pathology , Hallux Valgus/physiopathology , Pain/etiology , Pronation/physiology , Weight-Bearing/physiology , Adult , Case-Control Studies , Female , Hallux Valgus/complications , Humans , Pain/diagnosis , Severity of Illness Index , Shoes , Young Adult
13.
Foot (Edinb) ; 45: 101706, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33039908

ABSTRACT

BACKGROUND: The intrinsic foot muscles are vital for maintaining normal foot function. This study was conducted to systematically review the literature on the functional capacity and morphological characteristics of the intrinsic foot muscles in subjects with Hallux Valgus (HV) deformity. METHODS: A search was carried out in all available electronic databases, including Pub Med, Scopus, Embase and Web of Science, for identifying any relevant studies published from 1990 to October 2018. RESULTS: Three studies had investigated intrinsic foot muscle size using ultrasound imaging; two had reported electromyography parameters and four had measured the muscle force capacity. The results of the present review suggested that the functional capacity and morphological characteristics of intrinsic foot muscles are different in subjects with HV compared to those without this deformity. CONCLUSION: This review found scientific evidence on muscle performance impairment in the abductor hallucis and flexor hallucis brevis in subjects with HV deformity.


Subject(s)
Foot/pathology , Foot/physiopathology , Hallux Valgus/pathology , Hallux Valgus/physiopathology , Muscle, Skeletal/pathology , Muscle, Skeletal/physiopathology , Hallux Valgus/complications , Humans
14.
Clin Sports Med ; 39(4): 801-818, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32892968

ABSTRACT

Turf toe injuries should be recognized and treated early to prevent long-term disability. The accurate clinical assessment and radiological evaluation of appropriate cases is important. Both conservative and surgical treatments play a major role in getting athletes back to their preinjury level. There are more recent reported case series and systemic reviews that encourage operative treatment as early as possible for grade III turf toe injury. If the patient presents late from a traumatic hallux injury with subsequent degenerative changes or has hallux rigidus from other etiologies, a first metatarsophalangeal arthrodesis should be considered to minimize pain and improve function.


Subject(s)
Arthrodesis , Athletic Injuries/surgery , Foot Injuries/surgery , Hallux Rigidus/surgery , Hallux Valgus/surgery , Hallux/injuries , Metatarsophalangeal Joint/injuries , Arthritis/etiology , Arthritis/physiopathology , Arthritis/surgery , Athletic Injuries/physiopathology , Foot Injuries/etiology , Foot Injuries/physiopathology , Hallux/physiopathology , Hallux/surgery , Hallux Rigidus/etiology , Hallux Rigidus/physiopathology , Hallux Valgus/etiology , Hallux Valgus/physiopathology , Humans , Joint Instability/etiology , Joint Instability/physiopathology , Joint Instability/surgery , Metatarsophalangeal Joint/surgery , Treatment Outcome
15.
Orthop Surg ; 12(6): 1621-1626, 2020 Dec.
Article in English | MEDLINE | ID: mdl-32856421

ABSTRACT

OBJECTIVE: The aim of the present study was to evaluate commonly used approaches for detection of radiographic angles in hallux valgus deformity patients. METHODS: This retrospective study was conducted in patients with hallux valgus deformity at Wangjing Hospital of China Academy of Chinese Medical Sciences from January 2016 to January 2019. The inclusion criteria were: (i) postoperative dorsoplantar weight-bearing radiographs for the feet of patients with the hallux valgus; (ii) patients had been managed with a distal osteotomy of the first metatarsal and the osteotomized bone ends recovered. The exclusion criteria applied were as follows: (i) age > 65 years or < 18 years old; (ii) blurry image; (iii) previous history of severe foot trauma and surgery. Postoperative radiographs for hallux valgus were analyzed using six methods: by a line drawn through the long axis of the first metatarsal bone (method 1); an extended line drawn to bisect the shaft of the metatarsal at two levels with joined points of bisection (method 2); a line drawn to connect the center of the articular surface of the metatarsal head and the center of the proximal articulation (method 3); a line drawn from the center of the head of the first metatarsal head through the center of the base of the first metatarsal bone (method 4); a line drawn through the center of the head and the center of the proximal shaft (method 5); and a line drawn from the center of the head of the first metatarsal head through the center of the proximal articulation (method 6). The measurement results obtained were subjected to Bland-Altman analysis and consistency evaluation. RESULTS: A total number of 20 radiographs were collected for measurement. No statistically significant differences were found in the measurement values among the six methods (P > 0.05). The lowest values of the average measurement, standard deviation, and confidence interval were established in method 3, followed by those in methods 1 and 4. The standard deviation of the measurement value and the confidence interval in method 2 were the largest. Methods 1 and 4 had similar confidence intervals and were with a high consistency. Due to the nature of the retrospective study, no follow-up and complications were applicable in the present study. CONCLUSION: Line drawn through the long axis of the first metatarsal bone (method 1) and line drawn from the center of the head of the first metatarsal head through the center of the base of the first metatarsal bone (method 4) were reliable and well repeatable, and may be used for postoperative radiographs.


Subject(s)
Hallux Valgus/diagnostic imaging , Hallux Valgus/surgery , Osteotomy , Range of Motion, Articular , Adult , Hallux Valgus/physiopathology , Humans , Middle Aged , Radiography , Retrospective Studies
16.
J Am Acad Orthop Surg ; 28(14): e595-e603, 2020 Jul 15.
Article in English | MEDLINE | ID: mdl-32692095

ABSTRACT

Weight-bearing CT (WBCT) scans of the foot and ankle have improved the understanding of deformities that are not easily identified on radiographs and are increasingly being used by orthopaedic surgeons for diagnostic and preoperative planning purposes. In contrast to standard CT scans, WBCT scans better demonstrate the true orientation of the bones and joints during loading. They have been especially useful in investigating the alignment of complex pathologies such as adult-acquired flatfoot deformity in which patients have been found to have a more valgus subtalar joint alignment than in a normal cohort and high rates of subfibular impingement. Studies using WBCT scans have also provided new insight into more common lower extremity conditions such as hallux valgus, ankle fractures, and lateral ankle instability. WBCT scans have allowed researchers to investigate pronation of the first metatarsal in patients with hallux valgus compared with normal feet, and patients with lateral ankle instability have been found to have more heel varus than healthy control subjects. Understanding the application of WBCT scans to clinical practice is becoming more important as surgeons strive for improved outcomes in the treatment of complicated foot and ankle disorders.


Subject(s)
Ankle/diagnostic imaging , Ankle/physiopathology , Flatfoot/diagnostic imaging , Flatfoot/physiopathology , Foot/diagnostic imaging , Foot/physiopathology , Tomography, X-Ray Computed/methods , Weight-Bearing , Ankle/surgery , Ankle Fractures/diagnostic imaging , Ankle Fractures/physiopathology , Ankle Fractures/surgery , Ankle Joint/diagnostic imaging , Ankle Joint/physiopathology , Ankle Joint/surgery , Flatfoot/surgery , Foot/surgery , Hallux Valgus/diagnostic imaging , Hallux Valgus/physiopathology , Hallux Valgus/surgery , Humans , Joint Instability/diagnostic imaging , Joint Instability/physiopathology , Joint Instability/surgery , Patient Care Planning
17.
J Foot Ankle Res ; 13(1): 44, 2020 Jul 13.
Article in English | MEDLINE | ID: mdl-32660543

ABSTRACT

BACKGROUND: The prevalence of hallux valgus (HV) increases with age in females. Several studies have investigated the relationship between foot problems, including HV, and falls in older individuals. This study aimed to examine whether HV causes a decline in functional activity in young females and also evaluate the relationship between HV angle, functional activity, toe flexor strength, and plantar pressure. METHODS: We assessed 94 females (mean age, 19.6 ± 1.3 years; mean body mass index, 21.2 ± 2.0 kg/m2) not currently receiving treatment for lower limb disease. HV angle was determined using their footprint. Functional reach (FR) and maximum step length (MSL), toe flexor strength, and plantar pressure were measured. Plantar pressure was measured during walking. We also calculated FR and the pressure in eight regions (first toe, second through fifth toes, first metatarsal, second through fourth metatarsals, fifth metatarsal, midfoot, medial heel, and lateral heel). RESULTS: There were 39 and 55 participants in the HV and no HV groups, respectively. FR and MSL did not differ significantly between the HV and no HV groups. Toe flexor strength was significantly different between the HV and no HV groups (26.69 ± 9.68 vs. 32.19 ± 8.55, respectively) (p = 0.002, ß = 0.206). During walking, plantar pressure was significantly lower in the second through fifth toes in the HV group (p = 0.005, ß = 0.187). During FR, plantar pressure was significantly greater in the first metatarsal in the HV group (p = 0.016, ß = 0.338). HV angle was negatively correlated with toe flexor strength (r = - 0.315, p = 0.002, ß = 0.121) and plantar pressure during walking in the second through fifth toes (r = - 0.362, p < 0.001, ß = 0.047), and positively correlated with plantar pressure during FR in the first metatarsal (r = 0.308, p = 0.002, ß = 0.137). Toe flexor strength was negatively correlated with plantar pressure during FR in the second through fourth metatarsals (r = - 0.318, p = 0.002, ß = 0.115), and there was a positive correlation with MSL (r = 0.330, p = 0.001, ß = 0.092). CONCLUSIONS: This study confirmed that HV reduces toe flexor strength and affects forefoot pressure during walking and FR in young females. Moreover, the toe flexor strength affects MSL. Efforts to prevent the onset and deterioration of HV from a young age might help reduce the risk of falling when older.


Subject(s)
Disability Evaluation , Hallux Valgus/physiopathology , Physical Functional Performance , Walking/physiology , Cross-Sectional Studies , Female , Foot/physiopathology , Humans , Muscle Strength , Plantar Plate/physiopathology , Pressure , Toes/physiopathology , Young Adult
18.
Gait Posture ; 80: 137-142, 2020 07.
Article in English | MEDLINE | ID: mdl-32504941

ABSTRACT

BACKGROUND: Hallux valgus (HV) contributes to deficits in static balance and increased fall risk in older adults. Very limited research has examined dynamic balance deficits in walking in this population. These individuals generally walk slowly, as balance challenge is lesser at slow speeds. RESEARCH QUESTION: How does the dynamic balance of older adults with HV differ from healthy controls at controlled slow and fast walking speeds? METHODS: Nineteen older adults with HV and 13 healthy controls completed 5 continuous walking trials at 1.0 and 1.3 m·s-1 as whole body marker position and ground reaction force data were captured. Dynamic balance was evaluated using whole body center of mass (COM) and center of pressure (COP) inclination angles (IA) and duration of double support. RESULTS: There were no differences in measures of dynamic balance between older adults with and without HV at slow and fast speeds. At the faster speed, the peak sagittal plane COM-COP IA increased and the double support duration decreased, while the peak frontal plane COM-COP IA were not affected. SIGNIFICANCE: Older adults with HV do not exhibit deficits in dynamic balance during continuous walking at comfortable speeds when compared to healthy older adults.


Subject(s)
Hallux Valgus/physiopathology , Postural Balance , Walking Speed , Accidental Falls , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Male , Middle Aged
19.
J Healthc Eng ; 2020: 8929153, 2020.
Article in English | MEDLINE | ID: mdl-32300473

ABSTRACT

Metatarsal pain is a common pathological outcome in patients with a hallux valgus (HV) deformity. However, the relationship between the degree of HV deformity and metatarsal pain has not been systematically examined. The purpose of the present study was to investigate the correlation between metatarsal pain and the degree of HV deformity. Between October 2017 and September 2018, 512 HV patients (944 feet) participated in an evaluation of their HV angle (HVA) using X-ray images. The participants were divided into four groups corresponding to their HVA (<15°, 15° to 20°, 21° to 40°, or >40°). Load rate, impulse, contact duration, and contact area were measured and recorded as dynamic gait parameters using the RsScan system. Data were evaluated using SPSS statistical software. The visual analog scale (VAS) was used to assess metatarsal pain. For the four HV deformity groups, the peak value of impulse and contact duration was concentrated on the second and third metatarsals (Meta2 and Meta3) (P < 0.05); contact area was also shown on metatarsals 1, 2, and 5 (P < 0.05). Metatarsal pain on Meta2 had the highest VAS score (VAS: 6.57), followed by Meta3 (Mean VAS: 5.72). In the HV > 40° group, the load location on Meta2 was transferred to Meta1. The percent of pain attributed to Meta2 and Meta3 was also increased in this group. These findings illustrated that metatarsal pain was primarily located on Meta2 and Meta3 in the different degrees of HV deformity. This information can provide the location to target for pain relief and help guide further rehabilitation.


Subject(s)
Biomechanical Phenomena , Hallux Valgus/complications , Hallux Valgus/physiopathology , Metatarsal Bones/physiopathology , Pain/etiology , Adult , Aged , Female , Humans , Male , Middle Aged
20.
PLoS One ; 15(4): e0231015, 2020.
Article in English | MEDLINE | ID: mdl-32251429

ABSTRACT

Hallux valgus is a serious medical concern for classical ballet dancers. Although it is well-known that progression of hallux valgus is related to inappropriate movement techniques in classical ballet, the kinematic relationship between the degree of hallux valgus and ballet techniques has not been substantiated. To develop proper training methods that prevent progression of hallux valgus, this study aimed to investigate the relationship between the degree of hallux valgus and movement techniques in classical ballet. Seventeen female classical ballet dancers at the advanced college-level participated in this study. Kinematic analysis of standing and plié in the first position was conducted via video capture technique. The Pearson product-moment correlation analysis was performed to examine the degree of hallux valgus and the following three kinematic variables: (1) the extent to which turnout is forced by other joints in the lower extremity than the hip joint, (2) the direction difference between the knee and toe in the transverse plane, and (3) the pelvis obliquity angle. Among these kinematic variables, we found a significant correlation between the hallux valgus angle and the pelvis obliquity angle during plié (P = .045). The greater the hallux valgus angle, the greater the retroversion of the pelvis, a result which was contrary to our prediction. We present the first evidence that the degree of hallux valgus correlates with kinematics in a very basic technique of classical ballet.


Subject(s)
Dancing , Hallux Valgus/physiopathology , Biomechanical Phenomena/physiology , Dancing/physiology , Female , Humans , Pelvis/physiology , Pilot Projects , Severity of Illness Index , Transcription Factors/physiology , Video Recording , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL
...