A comparative study on imaging parameters of Chevron combined with Akin osteotomy and Scarf combined with Akin osteotomy for the correction of hallux valgus in patients at different ages

Objective:To study the imaging parameters of Chevron combined with Akin and Scarf combined with Akin for the correction of hallux valgus in patients of different ages.Methods:Eighty patients(152 feet)with hallux valgus who underwent Chevron combined with Akin and Scarf combined with Akin in our hospital were randomly selected.The patients were divided into young and middle-aged groups.Measure the hallux valgus angles(HVA),distal metatarsal articular angle(DMAA)and intermetatarsal angles(IMA)with professional X-ray measurement software and then reseach the effect of two the operation methods.Results:Young group:Chevron combined with Akin and Scarf combined with Akin significantly improved HVA and IMA,the difference had statistical significance(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).The improvement effect of the two groups on DMAA in young patients was not significant,and the difference had no statistical significance(P>0.05);Middle-aged group:Chevron combined with Akin and Scarf combined with Akin also significantly improved HVA and IMA(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).Chevron combined with Akin significantly improved DMAA in middle-aged and elderly patients,and the difference had statistical significance(P<0.05).Scarf combined with Akin did not significantly improve DMAA in middle-aged and elderly patients,and the difference had no statistical significance(P<0.05).Conclusion:Both Chevron combined with Akin and Scarf combined with Akin are effective and widely used.Chevron combined with Akin was able to improve DMAA in middle-aged and elderly patients.Therefore,Chevron combined with Akin is recommended for middle-aged and elderly patients with hallux valgus.

Radiological Characteristics and Anatomical Risk Factors in the Evaluation of Hallux Valgus in Chinese Adults

Background：There are no unified theories as to the anatomical changes that occur with hallux valgus,we investigated the radiological characteristics and anatomical risk factors for hallux valgus deformity in Chinese adults.Methods：We reviewed 141 patients with hallux valgus （206 feet; 15 males,126 females; mean age,58.5 years）.These patients attended Peking University People＇s Hospital from April 2008 to March 2014.All feet had intact radiological data,obtained using the Centricity RIS/PACS system.We measured hallux valgus angle （HVA）,1-2 intermetatarsal angle （IMA）,proximal articular set angle （PASA）,distal articular set angle,hallux interphalangeal angle,metatarsocuneiform angle,size of the medial eminence of the distal first metatarsal,tibial sesamoid position,and joint congruity of the first metatarsophalangeal joint （MTPJ）.Results：We found positive correlations between the HVA and IMA （r =0.279,P 〈 0.01） and HVA and PASA （r =0.358,P 〈 0.01）,but not for IMA and PASA （P 〉 0.05）.Feet were divided into three groups based on HVA severity.IMA （P 〈 0.05） and PASA （P 〈 0.05） in the mild group were significantly lower than that in the moderate and severe groups,with no significant difference determined for IMA or PASA between the moderate and severe groups （P 〉 0.05）.Feet were then grouped based on the shape of the first metatarsal head.Using this grouping,HVA was significant higher in the rounded shape （19.92°） than in a flat shape （17.66°）.The size of the medial eminence of the distal first metatarsal was positively correlated with HVA （r =0.185,P 〈 0.01）.The medial eminence in the moderate and severe groups was significantly larger than that in the mild group; moderate and severe groups were not significantly different.Conclusions：PASA enlargement is an adaptive change during early hallux valgus formation,and decompensation leads to subdislocation in the first MTPJ.A rounded first metatarsal head would thus predispose a foot to hallux valgus.Furthermore,bone proliferation at the medial eminence may also lead to early hallux valgus development.