No abstract available.
Hallux Valgus* ; Hallux*

PURPOSE: Medial capsulorrhaphy is additional hallux reduction method following various hallux reduction procedures and we are going to report author's opinion about several methods of medial capsulorrhaphy. MATERIALS AND METHODS: We performed three kinds of medial capsulotomy and imbricatory capsulorrhaphy in hallux valgus surgery. Through 8 cadavar study, we compared the easiness of sesamoid reduction and hallux valgus angle reduction. Also, we measured thickness of capsule in various portions. RESULTS: Longitudinal capsule incision and imbrication was useful in sesamoid reduction and vertical procedures was useful in hallux valgus angle reduction. The capsule thickness was measured thickest in dorsal and distal portioin. CONCLUSION: The methods of medial capsulorrhaphy should be planned preoperatively considering individual hallux deformities. These selected medial capsulorrhaphy can help the reduction of hallux valgus deformity correction and its maintenance
Congenital Abnormalities ; Hallux ; Hallux Valgus

PURPOSE: In order to achieve successful outcome for the hallux valgus surgery, it is mandatory to consider the possible associated hallux valgus interphalangeus, and therefore the hallux interphalangeal angle (HIA) other than hallux valgus angle (HVA) and intermetatarsal angle (IMA) has been well appreciated. The purpose of this study is to evaluate the incidence of hallux interphalangeal angle in the normal and hallux valgus feet and also the statistical correlations of HIA with HVA and IMA in the 2 groups. MATERIALS AND METHODS: The study is base on the standing foot AP radiographs of the 100 normal feet (HVA<12 degrees and IMA<9 degrees) and 100 hallux valgus feet (HVA>25 degrees and IMA>12 degrees). We measured the hallux valgus angle, intermetatarsal angle and hallux interphalangeal angle, where we defined the hallux valgus interphalangeus when the HIA was more than 10 degrees. We evaluated the incidence of the hallux valgus interphalangeus in the normal and hallux valgus groups and the correlations of the HIA with HVA and IMA. RESULTS: In normal feet group, hallux valgus interphalangeus comprised 82%, while there were only 20% of HVI in hallux valgus group. Among 200 total feet, there was negative correlations between the HVA and HIA as well as IMA and HIA statistically (p<0.01). CONCLUSION: There was lower incidence of hallux valgus interphalangeus in the hallux valgus group compared to the normal feet group.
Foot* ; Hallux Valgus* ; Hallux* ; Incidence*

PURPOSE: To study inter- and intra-observer reliabilities of computerized measurements of the angular parameters of hallux valgus deformity, using two different kinds of software tools for angle measurement on the digital radiography. MATERIALS AND METHODS: On 35 digital radiographies of standing foot anteroposterior view of hallux valgus, two observers (A, B) independently measured hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA1-2) twice, using two methods. In method I, an angle was determined from duplicated lines to longitudinal axes made for bisecting line on the target bones with software tool. In method II, an angle was calculated automatically and directly from bisecting lines (longitudinal axes) made on the target bones. We compared two methods using paired t-test to determine significance of differences. Inter- and intra-observer reliabilities were evaluated using the intraclass correlation coefficients (ICC). RESULTS: There were no significant differences between measurements of method I and II for each observer (p>0.05) and intraobserver reliability were good. (ICC>0.9) Inter-observer reliability for method I and II was good of the HVA (ICCs, 0.912 and 0.905) and moderate of the IMA1-2 (ICCs, 0.505 and 0.537). There were interobserver differences in HVA of method I and II. CONCLUSION: No significant difference was found statistically between measurements of method I and II. Both methods I and II would be acceptable to measure angular parameters of hallux valgus deformity.
Congenital Abnormalities ; Foot ; Hallux ; Hallux Valgus ; Software

PURPOSE: The distal chevron osteotomy has gained popularity for the mild to moderate hallux valgus, but necessity of fixation is controversy. No fixation of distal chevron osteotomy cause instability, but fixation has problem which has pin site infection and irritability, extension of operation time, discomfort of rehabilitation. So, the author was going to analyse and compare with and without in the fixation of distal chevron osteotomy. MATERIALS AND METHODS: Between 2004 and 2005, a total 18 patients (20 feet) following with and without in fixation of distal chevron osteotomies. The fixation group (A) was performed for the treatment of 10 patients (10 feet) and no fixation group (B) was done to 8 patients (10 feet). RESULTS: On group A, the mean first MTP (metatarsophalangeal) angle corrected 17 degrees pre-operatively to average 29 degrees (range; 20-37 degrees) and the mean first IM (intermetatarsal) angle corrected 10 degrees pre-operatively to average 15 degrees (range; 9-18 degrees). On Group B, the mean first MTP angle corrected 16 degrees pre-operatively to average 29 degrees (range; 18-33 degrees) and the mean first IM angle corrected 7 degrees pre-operatively to average 13 degrees (range; 9-16 degrees) (P>0.05). Clinical results, based on AOFAS score showed an improvement in the overall results. CONCLUSIONS: Comparing the clinical and radiographic results of the distal chevron osteotomies no difference in with and without fixation of distal chevron osteotomies.
Hallux Valgus* ; Hallux* ; Humans ; Osteotomy* ; Rehabilitation

PURPOSE: To statistically evaluate the contributing role of the 3 radiographic factors (Obliquity, Asymmetry, Joint deviation) of the hallux valgus interphalangeus with comparison to the normal control group. MATERIALS AND METHODS: The study is based on the standing foot AP radiographs of the 77 feet (56 patients) of the hallux valgus interphalangeus out of 119 feet of randomly sampled patients of the age range 20 to 60. Fractures or other foot disorders have been excluded. Obliquity, asymmetry and joint deviation factors formed by proximal and distal phalanges of hallux are measured by one observer and evaluated the statistical significance of the contribution of the 3 factors to the hallux interphalangeal angle (HIA). RESULTS: The average age of the patients were 36.0 years old and average HIA was 14.5 degrees +/- 2.8 degrees. Obliquity was measured 4.8 degrees +/- 2.90 degrees, asymmetry 8.2 degrees +/- 3.28 degrees and joint deviation 2.0 degrees +/- 1.85 degrees. All 3 factors showed the statistical significance as the contributing factors to the HIA and among them, the asymmetry played the biggest role (p<0.05). CONCLUSION: Hallux interphalangeal angle is formed by 3 radiographic factors (Obliquity, Asymmetry, Joint deviation), and among them the asymmetry factor plays the biggest role.
Foot ; Hallux Valgus* ; Hallux* ; Humans ; Joints

OBJECTIVE: To find out whether the footprint test was significant as a screening test in hallux valgus (HV) patients. METHOD: The standing AP radiography and the static footprint were performed on 26 general patients, 52 feet total, ranging in age from 15~70 years. As markers of the footprint test, the angles that we want to measure were designated as H and H' angles. RESULTS: The HV angle on plain radiography correlated significantly to the H angle of the footprint test (r=0.75), and presented as HV angle=1.012H+2.723. The HV angle on plain radiography inversely correlated significantly to the H' angle (r=-0.56) and presented as HV angle=-0.731H' +90.953. CONCLUSION: The footprint test could be used as a screening test for hallux valgus prior to plain radiography. HV angle in standing AP radiograph could be predicted by measuring the H and H' angle on the static footprint. Supplement studies on variable factors such as age, gender, etc. are required for further study.
Foot ; Hallux ; Hallux Valgus ; Humans ; Mass Screening

PURPOSE: This study was performed to compare the contact area between three different correcting angles after the proximal crescentic and Ludloff osteotomies of the first metatarsal. MATERIALS AND METHODS: We used the two sawbone models. Proximal crescentic (PCO) and Ludloff osteotomies (LO) were performed and secured using K-wires under the correcting intermetatarsal angle (IMA) 5degrees, 10degrees, and 15degrees. Then each 6 osteotomized model was scanned five times and measured the contact area using the calculating program. We excluded the highest and lowest values. RESULTS: The mean area of cutting surface was 189 mm2 in PCO, 863 mm2 in LO. The mean contact area (contact ratio; contact area x100/area of cutting surface) of PCO was 149 mm2 (79%) in 5degrees, 139.5 mm2 (74%) in 10degrees, 107 mm2 (57%) in 15degrees IMA. The mean contact area (contact ratio) of LO was 711 mm2 (82%) in 5degrees, 535.5 mm2 (62%) in 10degrees, 330 mm2 (38%) in 15degrees IMA. CONCLUSION: A significant decrease in the contact area and contact ratio according to increase in correcting IMA was noticed in LO. We recommend the PCO rather than LO, when the IMA is needed to correct over 15degrees.
Hallux Valgus ; Metatarsal Bones ; Osteotomy

PURPOSE: This study was performed to compare the contact area between three different correcting angles after the proximal crescentic and Ludloff osteotomies of the first metatarsal. MATERIALS AND METHODS: We used the two sawbone models. Proximal crescentic (PCO) and Ludloff osteotomies (LO) were performed and secured using K-wires under the correcting intermetatarsal angle (IMA) 5degrees, 10degrees, and 15degrees. Then each 6 osteotomized model was scanned five times and measured the contact area using the calculating program. We excluded the highest and lowest values. RESULTS: The mean area of cutting surface was 189 mm2 in PCO, 863 mm2 in LO. The mean contact area (contact ratio; contact area x100/area of cutting surface) of PCO was 149 mm2 (79%) in 5degrees, 139.5 mm2 (74%) in 10degrees, 107 mm2 (57%) in 15degrees IMA. The mean contact area (contact ratio) of LO was 711 mm2 (82%) in 5degrees, 535.5 mm2 (62%) in 10degrees, 330 mm2 (38%) in 15degrees IMA. CONCLUSION: A significant decrease in the contact area and contact ratio according to increase in correcting IMA was noticed in LO. We recommend the PCO rather than LO, when the IMA is needed to correct over 15degrees.
Hallux Valgus ; Metatarsal Bones ; Osteotomy

PURPOSE: To evaluate the validity and intra-rater, inter-rater reliability of the EMC device used to check the mobility of the first ray of the foot. MATERIALS AND METHODS: Sixty-nine cases (43 patients) of mild to severe hallux valgus feet were enrolled in this study. For an analysis of the validity of the EMC device, the dorsal mobility of the first ray of the foot was measured using the modified Coleman block test and EMC device. The intra- and inter-rater reliability of EMC device was evaluated by measuring the dorsal mobility of the first ray of the foot twice with three independent raters blinded to other's results. The results were analyzed for the intra-rater reliability and for inter-rater reliability. RESULTS: The mean value of the dorsal mobility of the first ray of the foot by the EMC device and modified Coleman block test was 8.3 mm (range; 4.3-12.3 mm) and 7.4 mm (range; 3.4-10.3 mm), respectively. There was a significant difference between the EMC device and modified Coleman block test (p<0.05). However, both the measured data, showed a good correlation (Pearson correlation coefficient=0.84). The paired t-test for intra-rater reliability and ANOVA testing for inter-rater reliability showed no statistically significant difference. CONCLUSION: The EMC device is reliable and valid for measuring the mobility of the first ray of the foot.
Foot* ; Hallux Valgus ; Reproducibility of Results*