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Hallux Abducto Valgus

Daniel J Hatch, Robert D Santrock, Bret Smith, Paul Dayton, Lowell Weil
One of the most common procedures performed in the foot and ankle is correction of hallux abducto valgus deformity or "bunion surgery." Most foot and ankle surgeons recognize the challenges associated with defining each patient's individual deformity and selecting the optimal procedure for the best long-term results. Using current 2-dimensional algorithms that focus on the severity of the transverse plane deformity, surgical outcomes have varied. In the past 10 years, high recurrence and complication rates for popular procedures have been reported...
May 18, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Regina C Fiacco, Garen M Ream, Charlotte Wilson, R Shane Tubbs, Marios Loukas, Piotr B Kozlowski, Anthony C DiLandro, Kevin T Jules, Anthony V D'Antoni
There is heterogeneity in the literature regarding the anatomy, exact location, and definition of the intersesamoid ligament (IL). Anatomic knowledge of the IL and its variations are important for surgeons who undertake corrective surgery for hallux abducto valgus (HAV). The IL was dissected in 16 feet from 32 formalin-fixed cadavers (12 females, four males; mean age at death, 76.6 years) to examine its morphology. The length, width, and thickness of its constituent bands were recorded with a digital caliper...
November 3, 2017: Curēus
W Bret Smith, Paul Dayton, Robert D Santrock, Daniel J Hatch
Hallux-abducto-valgus or "bunion" surgery is one of the most common surgical procedures for the foot and ankle specialist. As our understanding of the hallux-abducto-valgus deformity has grown, it is becoming clear that the anatomic CORA of the deformity may lie at the tarsometatarsal joint. There is also the component of the 3-dimensional nature of the deformity that may be best addressed at this CORA. With these issues in mind, it was necessary to address the shortcomings of the traditional Lapidus procedure and progress toward more consistent, instrumented steps that could address the 3-dimensional nature of the deformity...
January 2018: Clinics in Podiatric Medicine and Surgery
Malcolm Paul Formosa, Alfred Gatt, Cynthia Formosa
BACKGROUND: The aim of this study was to determine the quality of life in patients living with hallux abducto valgus deformity before and after a taping technique. METHODS: This study used a time series, quasi-experimental, same-subject design. Thirty-five patients with hallux abducto valgus were recruited in this study. Nonelastic zinc oxide tape was applied for 4 weeks. The Foot Health Status Questionnaire was used to assess the quality of life of participants before and after the intervention...
July 2017: Journal of the American Podiatric Medical Association
Paul Dayton, Mindi Feilmeier
We reviewed the radiographic results of a group of patients who had undergone triplane correctional tarsometatarsal arthrodesis for symptomatic hallux abducto valgus with metatarsus primus abducto valgus. Of the 21 feet included in the present review, 17 (81%) displayed radiographic findings of metatarsal pronation preoperatively based on axial sesamoid views and positive lateral round sign on anteroposterior radiographs. At a mean follow-up period of 5.2 ± 1.6 months, a significant improvement in the tibial sesamoid position (TSP) on both anteroposterior (AP) and axial radiographs was measured...
September 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Midori Higashi, David Shofler, Karim Manji, Keith Penera
The size of the radiographic first intermetatarsal (IM) angle is one of the main considerations in selecting a surgical procedure for hallux abducto valgus. Instead of directly measuring the IM angle with a goniometer or a virtual measurement system, physicians will often estimate the size of the IM angle by direct visual estimation. The purpose of the present study was to determine the accuracy of visual estimation of the IM angle size compared with direct measurement. A total of 45 respondents, composed of students, residents, and attending physicians, reviewed a series of radiographs with IM angles varying from 6° to 19°...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Eduardo Perez Boal, Ricardo Becerro de Bengoa Vallejo, Miguel Fuentes Rodriguez, Daniel Lopez Lopez, Marta Elena Losa Iglesias
BACKGROUND: Hallux abducto valgus (HAV) is one of the most common forefoot deformities in adulthood with a variable prevalence but has been reported as high as 48%. The study proposed that HAV development involves a skeletal parameter of the first metatarsal bone and proximal phalanx hallux (PPH) to determine if the length measurements of the metatarsal and PPH can be used to infer adult HAV. METHODS: All consecutive patients over 21 years of age with HAV by roentgenographic evaluation were included in a cross-sectional study...
2016: PloS One
Jeffrey E McAlister, Christopher F Hyer, Trevor E Black
First metatarsophalangeal joint arthritis can stem from a biomechanical imbalance as in hallux abducto valgus, metabolic arthritidies such as rheumatoid or gout, and even in posttraumatic cases. Advanced arthritis in the foot and ankle can often become debilitating. Surgical intervention is often necessary. Revision of failed first metatarsophalangeal joint arthroplasty is often in the setting of bony erosion and lysis, cystic changes, and loss of bone stock. In this article, we describe first metatarsophalangeal distraction arthrodesis technique using tricortical calcaneus autograft with the aim of simplifying donor site graft harvesting and decreasing donor site morbidity while attaining successful osseous union...
September 9, 2016: Foot & Ankle Specialist
Nicolas Arcuri, Tzvi Bar-David, Simcha Pollack
We reviewed 33 consecutive Mau-Reverdin osteotomies in 23 patients performed for correction of hallux abducto valgus from November 2010 to May 2013. All patients were followed up and evaluated for a mean of 401 days and median of 360 days after surgery. In each foot, the preoperative first intermetatarsal angle, hallux abductus angle, and proximal articular set angle were obtained. The mean correction of these angles was as follows: intermetatarsal angle 10.5° ± 3.31°, hallux abductus angle 24.4° ± 8...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
José M Castillo-López, Pedro V Munuera-Martínez, Cristina Algaba-Guisado, María Reina-Bueno, Nadia Salti-Pozo, Alfonso Vargas-Macías
BACKGROUND: The foot is the main element of artistic creation in flamenco dancing. At the professional level, the foot undergoes high musculoskeletal demands, predisposing the development of podiatric pathologic disorders in this group. The principal objective of this study was to determine the most common foot lesions in professional female flamenco dancers. METHODS: In a cross-sectional observational study of 44 female professional flamenco dancers, the participants completed a short questionnaire about their demographic features, number of hours danced per week, and years of professional activity...
January 2016: Journal of the American Podiatric Medical Association
Guido A LaPorta, Ellianne M Nasser, Jennifer L Mulhern, D Scot Malay
The present report describes a new method of hallux abducto valgus deformity correction planning using the mechanical axis of the medial column (mechanical axis planning). This method of radiographic evaluation identifies an ideal position for the first metatarsal after correction and is useful regardless of the surgical procedure chosen. We retrospectively reviewed 200 radiographs to identify a "normal" value for the mechanical axis angle. We reviewed 100 radiographs of patients with hallux abducto valgus deformity (deformity group) and 100 radiographs of patients without hallux abducto valgus deformity (control group)...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Boyd J Andrews, Lawrence M Fallat, John P Kish
The chevron osteotomy is a popular procedure used for the correction of moderate hallux abducto valgus deformity. Fixation is typically accomplished with Kirschner wires or bone screws; however, in cystic or osteoporotic bone, these could be inadequate, resulting in displacement of the capital fragment. We propose using a locking plate and interfragmental screw for fixation of the chevron osteotomy that could reduce the healing time and decrease the incidence of displacement. We performed a retrospective cohort study for chevron osteotomies on 75 feet (73 patients)...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Enrique Morales-Orcajo, Javier Bayod, Ricardo Becerro-de-Bengoa-Vallejo, Marta Losa-Iglesias, Manuel Doblare
Hallux abducto valgus (HAV), one of the most common forefoot deformities, occurs primarily in elderly women. HAV is a complex disease without a clearly identifiable cause for its higher prevalence in women compared with men. Several studies have reported various skeletal parameters related to HAV. This study examined the geometry of the proximal phalanx of the hallux (PPH) as a potential etiologic factor in this deformity. A total of 43 cadaver feet (22 males and 21 females) were examined by means of cadaveric dissection...
July 2015: Medical & Biological Engineering & Computing
David W Jenkins, Kimbal Cooper, Evelyn G Heigh
BACKGROUND: Persons with intellectual disabilities frequently have podiatric conditions. Limited information exists on their prevalence in international cohorts of Special Olympics (SO) athletes. Findings from multiple United States (US) venues are compared to those from athletes screened at the 2011 Special Olympics World Summer Games in Athens, Greece (ATHENS). METHODS: Data from Fit Feet screenings from 2096 ATHENS participants was compared to 7192 US participants...
March 2015: Foot
Paul Dayton, Merrell Kauwe, Mindi Feilmeier
Of the >100 procedures that have been proposed to treat hallux valgus or the "bunion" deformity, most have focused on correction through metatarsal osteotomies at various levels combined with soft tissue balancing procedures at the first metatarsophalangeal joint. This paradigm of metatarsal osteotomy and soft tissue balancing has been so commonplace, any argument for a fundamental change to the approach becomes uncomfortable and seems unwarranted to most foot and ankle surgeons. However, the simple fact that so many procedures exist, with so many modifications of these procedures, can be interpreted as a failure of our basic paradigm of metatarsal osteotomy and soft tissue balancing...
January 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Michael B Canales, Matthew DeMore, Michael F Bowen, Duane J Ehredt, Mark C Razzante
First ray function and hallux misalignment after isolated tibial sesamoidectomy have been topics of debate. Although sesamoidectomy has been proved to be effective in the relief of sesamoid pain, many foot and ankle surgeons remain hesitant to perform the procedure fearing a possible joint perturbation. To our knowledge, the present study is the first to evaluate both laboratory and clinical evidence of the association between isolated tibial sesamoidectomy and hallux abducto valgus deformity. The bench study consisted of 10 cadaveric limbs that were dissected and prepared for testing...
January 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Nicholas G Argerakis, Lowell Weil, Lowell Scott Weil, Dimitrios Anagnostopoulos, Catherine A Feuerstein, Erin E Klein, Ashley K Boccio
STATEMENT OF PURPOSE: Excessive pronation of the rearfoot has been implicated as a destabilizing force in the progression of hallux abducto valgus. Although the scarf bunionectomy has been shown to effectively correct the intermetatarsal angle associated with hallux valgus deformity, its effect on the rearfoot has yet to be established. The purpose of this case series is to demonstrate the effect of the scarf bunionectomy on rearfoot alignment. METHODOLOGY: Medical records were reviewed to isolate patients who underwent unilateral or bilateral scarf bunionectomies (with or without akin osteotomy) who had complete medical records, follow-up of at least 12 months, and met the inclusion/exclusion criteria...
April 2015: Foot & Ankle Specialist
Thomas Zgonis
No abstract text is available yet for this article.
April 2014: Clinics in Podiatric Medicine and Surgery
Suzanne T Hawson
This article discusses physical therapy considerations after hallux valgus correction. Hallux valgus is a fairly common occurrence, and corrective surgery is an option when conservative measures fail. Symptoms such as pain, swelling, and difficulty walking may persist after surgical correction of bunion deformity that addresses soft tissue and bone structure. Physical therapy is helpful after corrective hallux valgus surgery to address impairments and continued dysfunction and to improve overall patient outcome expectations...
April 2014: Clinics in Podiatric Medicine and Surgery
Jason Morris, Michael Ryan
Proximal first metatarsal osteotomies have historically been associated with and limited to treatment of severe hallux valgus deformities. These procedures are powerful in deformity correction and overall realignment of first ray function because of their ability to correct closer to the deformity's origin. When considering all factors in bunion correction, they are good options for correction of a wide range of hallux abducto valgus deformities. This article discusses the use of proximal metatarsal osteotomies for correction of hallux valgus deformity, techniques to facilitate optimal outcome, and common complications of these osteotomies...
April 2014: Clinics in Podiatric Medicine and Surgery
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