Increased hallux angle in children and its association with insufficient length of footwear: A community based cross-sectional study

Abstract

BackgroundWearing shoes of insufficient length during childhood has often been cited as leading to deformities of the foot, particularly to the development of hallux valgus disorders. Until now, these assumptions have not been confirmed through scientific research. This study aims to investigate whether this association can be statistically proven, and if children who wear shoes of insufficient length actually do have a higher risk of a more pronounced lateral deviation of the hallux.Methods858 pre-school children were included in the study. The study sample was stratified by sex, urban/rural areas and Austrian province. The hallux angle and the length of the feet were recorded. The inside length of the children's footwear (indoor shoes worn in pre-school and outdoor shoes) were assessed. Personal data and different anthropometric measurements were taken. The risk of hallux valgus deviation was statistically tested by a stepwise logistic regression analysis and the relative risk (odds ratio) for a hallux angle ≥ 4 degrees was calculated.ResultsExact examinations of the hallux angle could be conducted on a total of 1,579 individual feet. Only 23.9% out of 1,579 feet presented a straight position of the great toe. The others were characterized by lateral deviations (valgus position) at different degrees, equalling 10 degrees or greater in 14.2% of the children's feet.88.8% of 808 children examined wore indoor footwear that was of insufficient length, and 69.4% of 812 children wore outdoor shoes that were too short. A significant relationship was observed between the lengthwise fit of the shoes and the hallux angle: the shorter the shoe, the higher the value of the hallux angle. The relative risk (odds ratio) of a lateral hallux deviation of ≥ 4 degrees in children wearing shoes of insufficient length was significantly increased.ConclusionsThere is a significant relationship between the hallux angle in children and footwear that is too short in length. The fact that the majority of the children examined were wearing shoes of insufficient length makes the issue particularly significant. Our results emphasize the importance of ensuring that children's footwear fits properly.

Foot shape and its relationship with somatic characteristics in pre-school children

“…Most authors agree that both hallux valgus and other toe deformities are not genetic, but result from abnormal reactions with footwear [13][14][15]. The research by Klein et al [16] covering a group of 858 pre-school children from an Austrian province showed that only 23.9% of feet presented a straight position of the great toe. In addition, 808 children wore too small shoes and 812 had inadequate outdoor footwear.…”

Investigation of Children's Plantar Pressure Distribution with Varied Angle of Hallux

“…vârful îngust ºi strâmt. La purtarea acestui tip de încãlþãminte, halucele este obligat sã se deplaseze în lateral, ceea ce ar putea contribui la deformarea de tip hallux valgus [1] ºi la o distribuþie anormalã a presiunii plantare. Întrucât purtarea acestui tip de încãlþãminte este nocivã pentru picioarele copiilor, studiile de evaluare sunt dificil de efectuat.…”

“…Cu privire la copiii sãnãtoºi, Klein ºi colab. [1] au mãsurat AoH la 800 de copii sãnãtoºi ºi au explorat corelaþia dintre lungimea interioarã a încãlþãmintei pentru copii ºi apariþia deformãrii de tip hallux valgus; în plus, Ferrari ºi colab. [10] au comparat distribuþia presiunii plantare la bãieþi ºi la fete pentru a explica de ce deformarea de tip hallux valgus se regãseºte de obicei la populaþia femininã.…”

“…When wearing this type of footwear, the hallux is forced to move laterally which could contribute to the hallux valgus deformity [1] and abnormal plantar pressure distribution. Since wearing this fault shoes are harmful to children's feet, the studies of evaluation are difficult to be made.…”

Hallux Valgus Correction in Young Patients with Minimally Invasive Technique

“…( Roddy et al, 2008) In children, Klein et al reported only 23.9% of children's feet with a straight position of the great toe; in all the rest, the position of the great toe varied between a hallux angle of 1 degree up to 19 degrees valgus position (14.2% with a valgus deviation of equal to or greater than 10 degrees). (Klein et al, 2009) A female preponderance of 2:1 was reported in a study of schoolchildren's feet (Wilkins, 1941); the ratio increases up to 3:1 in military recruits (Hewitt, 1953;Marwil & Brantingham, 1943), until to reach approximately the ratio of 15:1 in adult patients (Hardy & Clapham, 1951). Therefore, the prevalence in women increased as patient age increased, also probably due to the use of fashionable female shoes.…”