OBJECTIVE: To explore short-term clinical efficacy of minimally invasive diagnosis and treatment system for hallux valgus in guiding the treatment of hallux valgus. METHODS: From March 2021 to November 2023, 68 patients (136 feet) with hallux valgus were treated under guidance of minimally invasive diagnosis and treatment system, including 12 males and 56 females;aged from 25 to 68 years old with an average of (42.5±8.5) years old, the course of disease ranged from 3.2 to 15.6 years with an average of (10.3±2.6) years. The changes of hallux valgus angle (HVA) and intermetatarsal angle (IMA), visual analog scale (VAS) and American Orthopaedic Foot Ankle Society (AOFAS) forefoot score were recorded and compared before operation and 12 months after operation. RESULTS: Sixty-five patients (130 feet) were followed up for 12 to 15 months with an average of (13.8±0.5) months, 3 patients (6 feet) were not followed up as required. HVA and IMA improved from (35.5±3.5) ° and (12.5±2.0) ° before operation to (10.5±2.5) ° and (8.5±1.5) °12 months after operation, respectively, with statistically significant differences (P<0.05);VAS decreased from (5.5±1.2) before operation to (1.2±0.5) at 12 months after operation, and the difference was statistically significant (P<0.05);AOFAS forefoot score increased from (50.6±5.1) before operation to (93.8±5.6) at 12 months after operation, with a statistically significant difference (P<0.05). Among them, 102 feet were got excellent result, 24 feet good, and 4 feet fair. Two patients were developed calf intermuscular vein thrombosis, and were cured after 3 months of symptomatic treatment. CONCLUSION Under the guidance of minimally invasive diagnosis and treatment system for hallux valgus, the treatment of HV could obviously improve HVA and IMA, and significantly alleviate pain symptoms, and accelerate functional recovery.
Humans ; Hallux Valgus/diagnosis* ; Male ; Female ; Middle Aged ; Adult ; Aged ; Minimally Invasive Surgical Procedures/methods* ; Treatment Outcome

Hallux Valgus ; diagnosis ; therapy ; Humans ; Metatarsal Bones ; Metatarsalgia

Hallux valgus is a lateral deviation of the first phalanx and medial deviation of the first metatarsal at the first metatarsophalangeal (MP) joint. Its incidence has increased due to developing footwear. The etiologies include fashion footwear, genetic causes, anatomical abnormality around the foot, rheumatoid arthritis, and neuromuscular disorders. Physiologic alignment of the first MP joint is maintained by congruent and symmetric alignment of the articular surface of the first proximal phalanx and first metatarsal head, physiologic relationship of the distal first metatarsal articular surface and the first metatarsal shaft axis, and stable balance of soft tissue around the first MP joint and stable tarsometatarsal joint. Several factors have been associated with hallux valgus, including pes planus, hypermobility of the first tarsometatarsal joint, flattened shape of the first metatarsal head, increased distal metatarsal articular angle, and deformation of the medial capsular integrity. History and physical examination are very important to diagnosis of hallux valgus. Simple radiography provides information on deformity, particularly in weight-bearing anteroposterior and lateral radiographs. Understanding the etiologies and pathophysiology is very important for success in treatment of patients with hallux valgus.
Arthritis, Rheumatoid ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Diagnosis* ; Flatfoot ; Foot ; Hallux Valgus* ; Head ; Humans ; Incidence ; Joints ; Metatarsal Bones ; Physical Examination ; Radiography ; Weight-Bearing

In hallux valgus, one of the most common conditions affecting the forefoot, the first metatarsophalangeal joint is progressively subluxed due to lateral deviation of the hallux and medial deviation of the first metatarsal. Patients usually complain of medial prominence pain, commonly referred to as "bunion pain," plantar keratotic lesions, and lesser toe deformities such as hammer toe or claw toe deformities. The etiology of hallux valgus is multifactorial. Narrow high-heeled shoes or excessive weight-bearing have been suggested to be extrinsic factors contributing to the condition, and many other intrinsic factors also exist, such as genetics, ligamentous laxity, metatarsus primus varus, pes planus, functional hallux limitus, sexual dimorphism, age, metatarsal morphology, first-ray hypermobility, and tight Achilles tendon. When we evaluate patients with hallux valgus, careful history taking and meticulous examination are necessary. On the radiographic evaluation, we routinely measure the hallux valgus angle, intermetatarsal angle, and distal metatarsal articular angle, which are valuable parameters in decision making for bunion surgery. To prevent the development and progression of hallux valgus, a soft leather shoe with a wide toe box is usually recommended. The use of a toe separator or bunion splint may help in relieving symptoms. The purpose of hallux valgus surgery is to correct the deformity and maintain a biomechanically functional foot. When we decide on an adequate surgical option, we should consider the patient's subjective symptoms, the expectations of the patient, the degree of the de-formity, and the radiographic measurements in order to correct the deformity and prevent complications after surgery.
Achilles Tendon ; Congenital Abnormalities ; Decision Making ; Diagnosis ; Flatfoot ; Foot ; General Surgery ; Genetics ; Hallux Limitus ; Hallux Valgus* ; Hallux* ; Hammer Toe Syndrome ; History ; Humans ; Intrinsic Factor ; Ligaments ; Metatarsal Bones ; Metatarsophalangeal Joint ; Shoes ; Splints ; Toes ; Weight-Bearing

Among the many regions (joints) of the human extremities, the foot and ankle area has a variety of disorders, which seem difficult to diagnose mainly because the anatomy seems rather complex. There are two main regions i.e. ankle and foot where the foot is divided into forefoot, midfoot and hindfoot. Among the many disorders, some of the most common and important disorders such as hallux valgus, osteochondral lesion of talus and lateral ankle instability are summarized in the aspect of clinical manifestations, physical examination, differential diagnosis, radiographic findings, initial treatments and the criteria for the surgery. The recent trend of surgical treatment options have also been described with related references.
Animals ; Ankle ; Diagnosis, Differential ; Extremities ; Foot ; Hallux Valgus ; Humans ; Physical Examination ; Talus

OBJECTIVETo study sagittal mobility about the FTJ (first tarsometatarsal joint) and its relationship with the pathophysiology and treatment of hallux valgus patients.

METHODSAccording to Lee's method, FTJ sagittal mobility of 300 normal feet and 200 hallux valgus was measured, and its correlative factors were statistically analysed.

RESULTSFTJ sagittal mobility of 300 normal feet was 8.4 degrees +/- 2.3 degrees , and that of 200 hallux valgus was 11.7 degrees +/- 3.2 degrees , the difference was significant. The normal range of FTJ sagittal mobility was less than 13 degrees . The sagittal overmotion of FTJ had relation to the anatomical configuration of FTJ (P < 0.05), intercuneiform splitting (P < 0.01), transferred pain under the second metatarsal head (P < 0.01), and FTJ osteoarthritis (P < 0.01) had no relation to HVA (hallux valgus angle), IMA (intermetatarsal angle), second metatarsus medial diaphyseal cortex hypertrophy (P > 0.05).

CONCLUSIONLee's method is convenient and accurate. Both HVA and IMA can not represent the sagittal mobility measurement of FTJ, which should be routinely evaluated, especially for hallux valgus patients with type I FTJ. Lapidus procedure should be considered for patients with larger FTJ in combination with transferred pain under the second metatarsal head, intercuneiform splitting, FTJ osteoarthritis.

Adolescent ; Adult ; Aged ; Female ; Hallux Valgus ; diagnosis ; physiopathology ; surgery ; Humans ; Male ; Metatarsophalangeal Joint ; physiology ; surgery ; Middle Aged ; Osteotomy ; methods ; Range of Motion, Articular

OBJECTIVE: To show the prevalence of the dorsomedial cutaneous nerve (DMCN) injury in the hallux valgus and to evaluate whether the sensory nerve damage contributes to pain and sensory impairment in the great toe. METHOD: Sixty feet of healthy adults (normal group) and 26 feet of patients with hallux valgus (hallux valgus group) were evaluated with sensory nerve conduction study of DMCN. The prevalence of the nerve injury was compared between the two groups. Sensory nerve action potentials of DMCN in hallux valgus feet were analyzed and compared according to the patient's symptom and the severity of the radiographic measurements of the feet. RESULTS: The prevalence of DMCN injury was 42.3% of the hallux valgus group. The peak latency of the DMCN sensory action potential of the symptomatic feet showed statistically significant delay compared to the asymptomatic group (p<0.05). Delay of the peak latency and decrement of the amplitude of the DMCN were statistically significant among the three groups as the valgus deformity worsened (p<0.05). CONCLUSION: DMCN injury should be considered in addition to soft tissue injury or arthritis in the differential diagnosis of the pain, burning sensation or numbness associated with hallux valgus.
Action Potentials ; Adult ; Arthritis ; Burns ; Congenital Abnormalities ; Diagnosis, Differential ; Foot ; Hallux Valgus* ; Hallux* ; Humans ; Hypesthesia ; Neural Conduction* ; Prevalence ; Sensation ; Soft Tissue Injuries ; Toes