OBJECTIVE: To compare clinical effect of Ludloff operation on the clinical efficacy of patients with hallux valgus combined with hammertoe of the second toe. METHODS: The clinical data of 66 patients with hallux valgus treated with Ludloff surgery from July 2015 to July 2022 were retrospectively analyzed. According to exclusion criteria, 33 patients with hallux valgus combined with hammertoe were finally included as case group, and 33 patients with simple hallux valgus were paired as control group. There were 11 males and 22 females in case group, aged from 24 to 62 years old with an average of (33.6±12.7) years old;body mass index (BMI) ranged from 19 to 25 kg·m^-2 with an average of(21.7±3.1) kg·m^-2;17 patients on the left side and 16 patients on the right side;hallux valgus angle (HVA) ranged from 25° to 47° with an average of (36.3±10.2) °;the intermetatarsal angle (IMA) ranged from 13° to 21° with an average of (16.9±3.2) °. There were 12 males and 21 females in control group, aged from 22 to 61 years old with an average of (32.2±10.9) years old;BMI ranged from 18 to 26 kg·m^-2 with an average of (22.0±4.2) kg·m^-2;15 patients on the left side and 18 patients on the right side;HVA ranged from 26° to 46° with an average of (37.2±9.3) °;IMA ranged from 12° to 21° with an average of (17.3±4.7) °. HVA, IMA, American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores and visual analogue scale (VAS) were compared at 3, 6 and 12 months after operation between two groups. RESULTS: Both groups were completed 1 year postoperative follow-up. Postoperative cutaneous margin necrosis occurred in 2 patients of case group and incision rupture occurred in 1 patient of control group. There was no significant difference between two groups (χ²=0.058, P>0.05). Both groups were achieved bone union at stageⅠat 12 weeks after opertaion, and no recurrence of bunion was observed during follow-up. Three months after operation, AOFAS forefoot function score of case group was (73.4±8.6), which was lower than that of control group (82.1±10.3), and the difference was statistically significant (P<0.05). There were no significant differences in HVA, IMA, AOFAS and VAS between two groups at 6 and 12 months after operation (P>0.05). CONCLUSION Ludloff surgery for the treatment of bunions with malleform toe of the second toe is slow in the early postoperative functional recovery, but it did not affect the long-term clinical outcome of the patients.
Humans ; Hallux Valgus/physiopathology* ; Male ; Female ; Middle Aged ; Adult ; Retrospective Studies ; Hammer Toe Syndrome/physiopathology* ; Young Adult

OBJECTIVE: To compare clinical efficacy of intermetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy in treating moderate to severe hallux valgus (HV). METHODS: A retrospective analysis was conducted on clinical data of 42 patients with moderate to severe HV admitted from January 2022 to December 2022. According to different incisions, the patients were divided into medial incision group with 22 patients (22 feet) and intermetatarsal incision group with 20 patients (20 feet). In medial incision group, there were 3 males and 19 females, aged from 40 to 69 years old with an average of (55.0±11.4) years old;body mass index (BMI) ranged from 21 to 29 kg·m-2 with an average of (25.2±2.1) kg·m-2;the courses of disease ranged from 8 to 16 years with average of (12.0±2.2) years;11 patients with moderate deformity and 11 patients with severe deformity. In transplantar incision group, there were 3 males and 17 females, aged from 39 to 68 years old with an average of (53.0±7.5) years old;BMI ranged from 20 to 28 kg·m^-2 with an average of (24.8±1.9) kg·m^-2;the courses of disease ranged from 9 to 17 years with an average of (14.0±3.1) years;9 patients with moderate deformity and 11 patients with severe deformity. Hallux valgus angle (HVA) and the first-second intermetatarsal angle (IMA), American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores and complications between two groups before operation and 12 months after operation were observed and compared. RESULTS: All patients were successfully completed the surgery and were followed up for 12 to 15 months with an average of (13.52±1.65) months. There were no statistically significant difference in HVA and IMA between two groups before operation and 12 months after operation (P>0.05). AOFAS forefoot scores of medial incision group before operation and 12 months after operation were (45.0±6.8) and (86.0±6.7) respectively, and those of transmetatarsal incision group were (46.0±7.4) and (83.0±7.5) respectively. Postoperative AOFAS forefoot scores between two groups at 12 months were statistically significant compared with those of before operation (P<0.01). According to AOFAS forefoot scores, 8 patients got excellent result, 14 good in medial incision group;while 6 excellent and 14 good in transplantar incision group. At 12 months, postoperative AOFAS forefoot score of functional score of in medial incision group(38.0±2.5), was better than that in transplantar incision group (34.0±2.2), and the difference was statistically significant (P<0.05). One patient in medial incision group occurred HV deformity, mild numbness occurred in 3 toes in transplantar incision group, and 3 patients were dissatisfied with scar. No complications such as infection, nonunion of bones or ischemic necrosis of metatarsal heads occurred in either group. CONCLUSION Both intermetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy can effectively treat moderate to severe HV. The functional recovery after medial incision is better than that after intermetatarsal incision.
Humans ; Male ; Female ; Hallux Valgus/physiopathology* ; Middle Aged ; Osteotomy/methods* ; Adult ; Aged ; Retrospective Studies ; Treatment Outcome ; Metatarsal Bones/surgery*

To treat hallux valgus, minimally invasive osteotomy on 1st metatarsal neck,immobilization with "8-shape" bandagev was performed, and the effect was definited. The principles of osteotomy stability were analyzed from the osteotomy position, methods, direction and angle. The grinding drill was used to increase friction coefficient between the ends of osteotomy. Correct direction of osteotomy and suitable angle were the key point of stability. The immobilization with "8-shape" bandage complied with the principle of elastic fixation created the conditions for the slight movement of the osteotomy ends. Compared with internal fixation ,it was better on osteotomy healing,and the osteotomy ends were stable and healed with cartilage
Fracture Fixation, Internal ; methods ; Hallux Valgus ; physiopathology ; surgery ; Humans ; Metatarsal Bones ; physiopathology ; surgery ; Minimally Invasive Surgical Procedures ; methods ; Neck ; physiopathology ; surgery ; Osteotomy ; methods ; Wound Healing

PURPOSE: With differences between the sexes in foot bone anatomy and ligamentous laxity, there is the possibility that the results of hallux valgus surgery may also differ between the sexes. We aimed to compare the results of hallux valgus surgery between the sexes. MATERIALS AND METHODS: The authors retrospectively reviewed 60 males (66 feet) and 70 females (82 feet) who underwent distal or proximal chevron osteotomy for the treatment of hallux valgus deformity between June 2005 and December 2011. We compared the clinical and radiologic outcomes between the sexes. RESULTS: There were no statistically significant differences in demographics between the sexes. The mean American Orthopedic Foot and Ankle Society score, visual analogue scale for pain, and patient satisfaction at the last follow-up did not differ significantly between the sexes. The mean preoperative hallux valgus angle (HVA) and inter-metatarsal angle (IMA) were not significantly different between the sexes. At the last follow-up, the mean HVA was significantly greater in females (p=0.003) than in males; mean IMA was not significantly different between the sexes. The mean correction of HVA in males was significantly greater than that in females (p=0.014). CONCLUSION: There were no significant differences between the sexes regarding clinical outcomes after distal and proximal chevron osteotomy. However, male patients achieved greater correction of HVA than female patients. There is a possibility that sexual dimorphism of the foot may affect postoperative HVA.
Adult ; Aged ; Female ; Hallux Valgus/physiopathology/radiography/*surgery ; Humans ; Male ; Metatarsal Bones/physiopathology/radiography/*surgery ; Middle Aged ; Osteotomy/*methods ; Pain ; Pain Measurement ; Patient Satisfaction ; Postoperative Period ; Retrospective Studies ; Sex Factors ; Treatment Outcome

PURPOSE: With differences between the sexes in foot bone anatomy and ligamentous laxity, there is the possibility that the results of hallux valgus surgery may also differ between the sexes. We aimed to compare the results of hallux valgus surgery between the sexes. MATERIALS AND METHODS: The authors retrospectively reviewed 60 males (66 feet) and 70 females (82 feet) who underwent distal or proximal chevron osteotomy for the treatment of hallux valgus deformity between June 2005 and December 2011. We compared the clinical and radiologic outcomes between the sexes. RESULTS: There were no statistically significant differences in demographics between the sexes. The mean American Orthopedic Foot and Ankle Society score, visual analogue scale for pain, and patient satisfaction at the last follow-up did not differ significantly between the sexes. The mean preoperative hallux valgus angle (HVA) and inter-metatarsal angle (IMA) were not significantly different between the sexes. At the last follow-up, the mean HVA was significantly greater in females (p=0.003) than in males; mean IMA was not significantly different between the sexes. The mean correction of HVA in males was significantly greater than that in females (p=0.014). CONCLUSION: There were no significant differences between the sexes regarding clinical outcomes after distal and proximal chevron osteotomy. However, male patients achieved greater correction of HVA than female patients. There is a possibility that sexual dimorphism of the foot may affect postoperative HVA.
Adult ; Aged ; Female ; Hallux Valgus/physiopathology/radiography/*surgery ; Humans ; Male ; Metatarsal Bones/physiopathology/radiography/*surgery ; Middle Aged ; Osteotomy/*methods ; Pain ; Pain Measurement ; Patient Satisfaction ; Postoperative Period ; Retrospective Studies ; Sex Factors ; Treatment Outcome

OBJECTIVETo study changes in the radiographic appearance during weight-bearing and non-weigh-bearing in hallux valgus, and to analyse the correlation between the elasticity of plantar soft tissue of hallux valgus and the pain under the metatarsal head.

METHODSFrom May 2012 to October 2012, 240 feet of 120 patients with hallux valgus were enrolled in the study. The degrees of the pian under the metatarsal head of all the patients were observed. AP and lateral X-ray films of feet were taken on the condition of weight-bearing and non-weight-bearing. So the hallux valgus angle (HVA), the inter-metatarsal angle between the first and second metatarsals (IM1-2), the inter-metatarsal angle between the first and fifth metatarsals (IM1-5), top angle of the medial longitudinal arch (TAOTMLA),and anterior angle of the medial longitudinal arch (AAOTMLA) were measured on the X-ray films. The differences of HVA, IM1-2, IM1-5, TAOTMLA and AAOTMLA between two groups were compared, and the correlation between the changes of IM1-2, IM 1-5, TAOTMLA, AAOTMLA and the degree of the pain under the metatarsal head were analysed.

RESULTSOne hundred and forty-eight feet had the pain under the metatarsal head. The IM1-2, IM1-5 and TAOTMLA increased on weight-bearing position compared with those on non-weight-bearing position, but the HVA and AAOTMLA decreased on weight-bearing position compared with those on non-weight-bearing position. There was a moderate relationship between the changes of IM 1-2,IM1-5 and the degree of the hallux valgus deformity, as well as the relationship between the different of IM1-5 and the degree of the pian under the metatarsal head.

CONCLUSIONThe degree of the collapse of the arch of foot with hallux valgus becomes serious with its deformity increasing. The pain under the metatarsal head of hallux valgus increases with the increased changes of IM 1-2,IM 1-5 and TAOTMLA. Analysis of the X-ray observation indexes of hallux valgus on weight-bearing position and non-weight-bearing position has important significance in evaluating the degree of the collapse of the arch of foot with hallux valgus,preventing and curing the the pain under the metatarsal head.

Adult ; Aged ; Female ; Hallux ; anatomy & histology ; diagnostic imaging ; physiopathology ; Hallux Valgus ; complications ; diagnostic imaging ; physiopathology ; Humans ; Metatarsalgia ; complications ; diagnostic imaging ; physiopathology ; Middle Aged ; Radiography ; Weight-Bearing ; Young Adult

Plantar pressure distribution can reflect the force of several key points on foot while standing and walking. A comprehensive understanding of the plantar pressure distribution makes great sense in the following aspects: the understanding of the normal foot biomechanics and function, clinical diagnosis, measurement of disease extent, postoperative efficacy evaluation, and rehabilitation research. A simple plantar pressure measurement device was designed in this study. This paper uses FlexiForce flexible sensor to pickup plantar pressure signal and USB A/D board to do data acquisition. The data are transferred into a laptop and processed by a VB-based software which can display, remember and replay the data. We chose patients with hallux valgus and normal people to measure the pressure distribution and make contrast analysis of plantar pressure with this device. It can be concluded that people with hallux valgus have higher pressure on the second metatarsophalangeal joint and the distribution move outward. The plantar pressure of patients postoperative could be greatly improved compared to the preoperative. The function of this device has been confirmed.
Foot ; physiology ; Hallux Valgus ; physiopathology ; Humans ; Metatarsophalangeal Joint ; physiopathology ; Monitoring, Physiologic ; instrumentation ; Pressure ; Walking

BACKGROUNDA causal link between the metatarsus adductus and hallux valgus is not clear. The aim of this study was to investigate the configurations of the metatarsus adductus deformity by radiological measurements and reappraise the relationship between hallux valgus and metatarsus adductus.

METHODSThe first step was evaluation of the relationship between metatarsus adductus and hallux valgus on 143 dorsoplantar weight-bearing radiographs diagnosed as hallux valgus which was also known as bunions. Measurements including the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the Kilmartin angle (KA), the tibial sesamoid position (TSP), and metatarsus adductus angle were taken. The metatarsus adductus angle is defined by Sgarlato's angle (SMA) and Engel's angle (EMA) respectively.

RESULTSThe metatarsus adductus angle positively correlates with the HVA (r = 0.590, P = 0.000) and KA (r = 0.601, P = 0.000), yet negatively correlates with the grade of TSP, (r = -0.348, P = 0.000). Contradiction of diagnosis existed in 22 (22/100) subjects diagnosed as metatarsus adductus by SMA yet normal by EMA. In this group, the correlation between HVA and metatarsus adductus angle was negative (r = -0.472, P = 0.027).

CONCLUSIONSEMA and SMA defined metatarsus adductus by different deformity apexes. Metatarsus adductus configurations in that the apex of the deformity lay in either the base of metatarsals or tarsus. They respectively correlate positively or negatively to the HVA.

Adult ; Aged ; Aged, 80 and over ; Female ; Foot Deformities, Congenital ; diagnostic imaging ; physiopathology ; Hallux Valgus ; diagnostic imaging ; physiopathology ; Humans ; Male ; Metatarsus ; abnormalities ; diagnostic imaging ; Middle Aged ; Radiography ; Young Adult

OBJECTIVETo investigate efficacy of simple osteotomy for correct hallux valgus,and explore its scope and condition.

METHODSFrom December 2009 to April 2011, 20 patients (32 feet) with hallux valgus were treated by simple osteotomy. There were 1 male (1 foot), 19 females (31 feet) with an average age of 40 years (ranged, 22 to 64 years). The course of disease ranged from 2 to 31 years(mean 12 years). Among them, 6 feet were mild, 20 feet were moderate, 6 feet were serious. Patients had symptoms of metatarsophalangeal joint pain, but tensity of lateral soft tissue were normal. Hallux Valgus Angle (HVA) and Intermetatarsal Angle (IMA) were examined before and after treatment. The criteria of hallux valgus was used to evaluate the effects from valgus deformity, activity of metatarsophalangeal joint, satisfaction of patients.

RESULTSTwenty patients were followed up from 6 to 18 months with an average of 8.5 months. The wounds were healed well, no infection and metatarsal head necrosis occurred, 95.1% of patients were satisfied with the efficacy. Average AOFAS score increased from preoperative (53.1 +/- 7.5) points to the final follow-up (93.1 +/- l.9) points (P<0.05), the average correct HVA increased from preoperative (33.4 +/- 7.8) degrees to postoperative (11.9 +/- 3.6) degrees (P<0.05), the average IMA were decreased from preoperative (12.3 +/- 3.0) degrees to postoperative (6.3 +/- 1.9) degrees (P<0.05), tibial sesamoid position improved from 1.9 to 0.9 (P<0.05).

CONCLUSIONthe main pathological changes of hallux valgus patients with normal tension of lateral soft tissue is metatarsal adduction, simple osteotomy can get satisfactory results, no need to cut adductor muscle.

Adult ; Female ; Follow-Up Studies ; Hallux Valgus ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Metatarsal Bones ; diagnostic imaging ; physiopathology ; surgery ; Middle Aged ; Osteotomy ; methods ; Recovery of Function ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

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