Functional Dependence of IM and HV Angle in Hallux Valgus Deformity before and after Operative

Hallux valgus is a relatively common and multifaceted complex deformity of the front part of the foot. It is the result of multiple effects of innate (endogenous) and exogenous etiological factors with different degrees of influence. The degree of hallux valgus deformity is usually assessed by radiological values of hallux valgus (HV) and intermetatarsal (IM) angles. The aim of the paper is to justify the definition of hallux valgus deformity as a function of one angle, (HVA or IMA), and then to determine the functional connection and the most suitable function equalizing the values of the angles IMA and HVA. As hallux valgus is a double angulation deformity, the analytically determined connection between the HVA and IMA angles reduces the study of the deformity to the study of function with one argument, and makes the analysis of deformity changes before and after operative treatment simpler. For the determined connections between the angles, the values of linear proportionality coefficients and regression coefficients of corresponding linear functions of analytical equalization of the value of the IM angle and the degree of deformity for a given value of the HV angle were experimentally determined. The obtained results were checked on a sample of 396 operatively treated hallux valgus deformities. The presented analytical approach and the obtained functional links of IMA and HVA enable quantitative observation of the change in the degree of deformity based on the radiologically determined value of these angles, and the established nonlinear function will be useful for evaluating the expected value of the IM angle and the degree of deformity based only on the measured value of the HV angle. .

The Radiological Outcome of Surgical Correction of Hallux Valgus with Combined Scarf and Akin Osteotomies

Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.

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.