The Shape of the Lateral Edge of the First Metatarsal Head as a Risk Factor for Recurrence of Hallux Valgus

Okuda, Ryuzo; Koshi, Mitsuo; Yasuda, Toshito; Jotoku, Tsuyoshi; Kitano, Naoshi; Shima, Hiroaki

doi:10.2106/00004623-200710000-00010

Cited by 140 publications

(60 citation statements)

References 19 publications

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“…A recurrence of HV deformity is also reported in the literature. Many confounding factors are involved with this complication, including inadequate soft-tissue release, inadequate sesamoid reduction, abnormal shape of the metatarsal head, inappropriate postoperative protocol and inadequate intermetatarsal angle correction [1,18,31]. A cut-off point determining whether the amount of deformity correction is appropriate has not yet been identified.…”

Section: Discussionmentioning

confidence: 99%

Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus

Chuckpaiwong

2012

International Orthopaedics (SICOT)

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Purpose This study compared results of distal and proximal metatarsal osteotomy for moderate to severe hallux valgus in terms of radiographic correction and functional outcome. Methods We analyzed 125 moderate to severe hallux valgus surgeries. Patients were divided into two groups. Group 1 underwent distal metatarsal osteotomy, and group 2 underwent proximal metatarsal osteotomy. Patients were interviewed for functional scores before and one year after surgery. The anteroposterior (AP) weight-bearing radiography of the foot was taken before and one year after surgery. Results There were no significant differences in pain and function after one year in either group. Both groups experienced significant pain reduction and increase in all functional scores. There was significant improvement of hallux valgus and intermetatarsal angle corrections in group 2. There was less improvement in radiographic correction in group 1. Conclusion Either distal or proximal metatarsal osteotomy is an appropriate pain-relieving procedure and can increase functional outcome in moderate to severe hallux valgus. However, distal metatarsal osteotomy provides lower correction power.

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Section: Discussionmentioning

confidence: 99%

Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus

Chuckpaiwong

2012

International Orthopaedics (SICOT)

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“…Commonly referred to as a bunion deformity, HV is characterized by the progressive subluxation and valgus angulation of the first metatarsophalangeal joint (1MTPJ) in combination with pronation of the proximal phalanx [2][3][4]. Genetic predisposition, inappropriate shoe wear, trauma and biomechanical compensation for structural and functional deformities (hindfoot eversion) have been reported as contributors to this disorder [3,5].…”

Section: Introductionmentioning

confidence: 99%

The impact of hallux valgus on foot kinematics: A cross-sectional, comparative study

et al. 2010

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“…Linear shape was defined as grade 0, and round shape was defined as grade 1. These definitions are different from the original method [4], however it is difficult to evaluate severely destructive cases in RA, then the definition was modified and simplified (Linear shape means non-pronation of first metatarsal, while round shape means pronation of first metatarsal) in this study. The grade of the dislocation of the second MTP joint was defined as grade 0 (group D0) if no subluxation (normal or joint space narrowing without lateral shift of proximal phalanx: dorsoplantar view of the foot X-ray picture), or defined as grade 1 (group preD2) if translation of the MTP joint (lateral shift of proximal phalanx and/or overlapping of the base of proximal phalanx and the metatarsal head: dorsoplantar view of the foot X-ray picture) was noted, and as grade 2 (group D2) if complete dorsal dislocation (base of proximal phalanx completely overcomes the metatarsal head: dorsoplantar view of the foot X-ray picture) was noted.…”

Section: Forefootmentioning

confidence: 99%

“…The shape of first metatarsal head was also checked to evaluate pronation of the first metatarsal bone [4]. Linear shape was defined as grade 0, and round shape was defined as grade 1.…”

Section: Forefootmentioning

confidence: 99%

“…Enlargement of the intermetatarsal 1 and 2 (M12) angle and intermetatarsal 1 and 5 (M15) angle, metatarsus primus varus (MPV) angle, and pronated deformity of the first metatarsal joint are known to associate with HV. [2][3][4]. In addition, limited Lisfranc complex mobility [2] and medial column sagittal instability [5] are known risk factors for rapid progression of HV.…”

Section: Introductionmentioning

confidence: 99%

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Hind-mid-forefoot Deformity in Hallux Valgus Deformity in Rheumatoid Arthritis: Radiographic Evaluation Grouped by Existence of Dorsal Dislocation of Second Metatarsophalangeal Joint

Tsuboi¹

2013

Rheumatol Curr Res

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Hallux valgus deformity combined with dorsal dislocation of the second metatarsophalangeal joint is frequently observed in rheumatoid arthritis cases. However, hallux valgus deformity without lesser toe dislocation is also seen in rheumatoid cases. Dislocated second toe cause the loss of the lateral support on the hallux, suggesting the importance to confirm the state of lesser toe MTP joint when assessing the risk of HV recurrence after surgery, and there may be some differences in the mechanical transmission between hind-mid and forefoot based on whether dorsal dislocation of the MTP joint in the lesser toe is present, although findings are unclear. This study examined the relationship between radiographic findings from the hind, mid, and forefoot and hallux valgus angle in rheumatoid arthritis cases grouped based on the presence or absence of dorsal dislocation of the second metatarsophalangeal joint. X-rays of 160 feet and ankles with rheumatoid arthritis were evaluated for the first metatarsophalangeal Larsen grade, existence of second metatarsophalangeal dorsal dislocation, hallux valgus angle, intermetatarsal angle between the first and second intermetatarsals, shape of the first metatarsal head, position of the sesamoid, the metatarsus primus varus angle, diastasis between the base of the first and second metatarsals, angle between long axis of the talus and short axis of the navicular, internal arch angle, tibio-calcaneal angle, and calcaneal lateral offset. Based on Pearson product-moment correlation coefficient test, involvement of hindfoot deformity should always be considered when assessing hallux valgus deformity in rheumatoid arthritis patients. Although mechanism of mechanical transmission through hindfoot to Lisfranc joint seems to be different by the presence or absence of dorsal dislocation of the second metatarsophalangeal joint, Lisfranc looseness also must be considered when assessing hallux valgus including the surgery to avoid the progression or recurrence in rheumatoid arthritis cases. Dorsal dislocation of the second metatarsophalangeal joint strongly influences the exacerbation of hallux valgus in rheumatoid arthritis cases. Thus, it is may be important to achieve adequate reduction of the second metatarsophalangeal joint dislocation and make a stable metatarsophalangeal joint to avoid recurrence of hallux valgus after forefoot surgery in rheumatoid arthritis.

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The Shape of the Lateral Edge of the First Metatarsal Head as a Risk Factor for Recurrence of Hallux Valgus

Cited by 140 publications

References 19 publications

Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus

Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus

The impact of hallux valgus on foot kinematics: A cross-sectional, comparative study

Hind-mid-forefoot Deformity in Hallux Valgus Deformity in Rheumatoid Arthritis: Radiographic Evaluation Grouped by Existence of Dorsal Dislocation of Second Metatarsophalangeal Joint

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