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Hallux valgus

Robin C Lenz, Darshan Nagesh, Hannah K Park, John Grady
BACKGROUND: Resection of the medial eminence in hallux valgus surgery is common. True hypertrophy of the medial eminence in hallux valgus is debated. No studies have compared metatarsal head width in patients with hallux valgus and control patients. METHODS: We reviewed 43 radiographs with hallux valgus and 27 without hallux valgus. We measured medial eminence width, first metatarsal head width, and first metatarsal shaft width in patients with and without radiographic hallux valgus...
September 2, 2016: Journal of the American Podiatric Medical Association
Viktor Feldman, Meir Nyska, Niv Marom, Omer Slavin, Yaron S Brin, Uri Farkash, Ezequiel Palmanovich
BACKGROUND: This study was designed to measure transverse forces between the 1st and 2nd metatarsals after reducing the intermetatarsal angle (IMA) in normal and hallux valgus (HV) feet, during non weight-bearing and weight-bearing phases of gait. METHODS: Four cadaver feet, three normal and one with hallux valgus, were used. A new suture button device (CyclaPlex™) composed of screw-type buttons connected with a wire was implanted at the mid-shaft of the 1st and 2nd metatarsals of all the feet...
October 17, 2016: Journal of Orthopaedic Surgery and Research
M Balasubramanian, H Lord, S Levesque, H Guturu, F Thuriot, G Sillon, A M Wenger, D L Sureka, T Lester, D S Johnson, J Bowen, A R Calhoun, D H Viskochil, G Bejerano, J A Bernstein, D Chitayat
BACKGROUND: In 1993, Chitayat et al., reported a newborn with hyperphalangism, facial anomalies, and bronchomalacia. We identified three additional families with similar findings. Features include bilateral accessory phalanx resulting in shortened index fingers; hallux valgus; distinctive face; respiratory compromise. OBJECTIVES: To identify the genetic aetiology of Chitayat syndrome and identify a unifying cause for this specific form of hyperphalangism. METHODS: Through ongoing collaboration, we had collected patients with strikingly-similar phenotype...
October 13, 2016: Journal of Medical Genetics
A L Ambrosoli, L Guzzetti, M Chiaranda, S Cuffari, M Gemma, G Cappelleri
We compared the effect of two different positions of a sciatic nerve catheter within the popliteal fossa on local anaesthetic consumption and postoperative analgesia in patients undergoing day-case hallux valgus repair. Eighty-four patients were randomly allocated to receive a sciatic nerve catheter either between the tibial and peroneal components (sciatic group) or medial to the tibial nerve (tibial group). The primary endpoint was postoperative local anaesthetic consumption, while secondary endpoints were pain scores, number of occasions where sleep was disturbed by pain and incidence of insensate limb and foot drop at 24 h and 48 h postoperatively...
November 2016: Anaesthesia
Dong Yeon Lee, Sang Gyo Seo, Eo Jin Kim, Sung Ju Kim, Kyoung Min Lee, In Ho Choi
BACKGROUND: Multi-segment Foot Models (MFM) have increased in use for both clinical and research applications; however, little is known about the gender differences of inter-segmental motions within the foot and ankle during gait. The objectives of this study were to analyze the gender differences of inter-segmental foot motion during gait in healthy young adults using a MFM with a 15-marker set. METHODS: One hundred healthy adults (50 males, 50 females) between 20 and 35 years of age who had normal function and no radiographic abnormality, were evaluated...
October 7, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Sean Booth, Abhijit Bhosale, Abubakar Mustafa, Ravi Shenoy, Anand Pillai
BACKGROUND: Symptomatic Hallux valgus can be treated with metatarsal osteotomy combined with proximal phalangeal osteotomy, however this might not be sufficient to treat severe HV deformities. METHODS: Fifteen feet in eleven female patients treated with double first metatarsal and proximal phalanx osteotomies without lateral release were prospectively studied and outcome measures including radiological angles and validated patient reported outcome scores collected...
September 20, 2016: Foot
Spenser J Cassinelli, Renee Herman, Thomas G Harris
: Hallux valgus is the most common disorder of the hallux and often results in pain, functional disability, and impaired gait patterns. The goals of surgical management are to correct the deformity while improving patients' pain and function. Traditional treatment of moderate to severe hallux valgus deformities consist of proximal osteotomy and/or arthrodesis given their powerful corrective ability. Despite their corrective power, proximal osteotomies are more technically demanding, have a higher rate of complications, and require a more restricted post-operative recovery...
October 2016: Foot & Ankle International
I S Hettigama, H K G Punchihewa, N K Heenkenda
BACKGROUND: Foot ailments are common among schoolchildren, some of which may be attributed to wearing ill-fitting footwear. As schoolchildren often participate in athletic activity, they are doubly vulnerable to foot ailments, and are particularly vulnerable to conditions such as hallux valgus, Achilles tendonitis, athlete's foot, corns and calluses. Thus, there is an acute need for the design and manufacture of ergonomic footwear for this target group. While research on appropriate footwear for children has been carried out in relation to child populations in other societies, research on the circumstances of Sri Lankan schoolchildren is lacking...
October 17, 2016: Work: a Journal of Prevention, Assessment, and Rehabilitation
Robert Vander Griend
BACKGROUND: Operative correction of a symptomatic hallux valgus interphalangeus (HVI) deformity is often achieved with an osteotomy at the proximal end of the proximal phalanx (Akin osteotomy). However, the apex of the typical HVI deformity (center of rotation angle) is at the interphalangeal joint of the hallux. This study was done to evaluate the results of performing a medial closing wedge osteotomy at the distal end of the proximal phalanx. METHODS: Thirty-three patients (33 feet) underwent an osteotomy at the distal end of the proximal phalanx for correction of HVI...
September 26, 2016: Foot & Ankle International
Jin Su Kim, Hun Ki Cho, Ki Won Young, Sang Young Lee, Ji Soo Kim, Kyoungtae Lee
BACKGROUND: Scarf osteotomy has been used in hallux valgus surgery due to its large fixation surface for screws and low postoperative complications. However, screws may cause skin irritation from their head, which may require an additional surgical procedure to remove. METHODS: This study included 115 patients (106 females and 9 males, 115 feet) who underwent hallux valgus correction with a scarf osteotomy using bioabsorbable screws between September 2010 and September 2012...
September 25, 2016: Foot & Ankle International
Rodrigo Díaz Fernández
BACKGROUND: Percutaneous surgery to correct deformities of the forefoot presents the advantages of using a minimal incision, which involves less soft tissue damage and less risk of wound complications. For severe deformities, percutaneous techniques have not been proven as effective. We propose a technique for the treatment of severe hallux valgus. METHODS: In a sample of 52 feet operated on 48 patients, we performed a double percutaneous osteotomy (closure proximal osteotomy and a distal Akin) or triple when a Reverdin-Isham osteotomy was added...
September 23, 2016: Foot & Ankle International
Jun Young Choi, Ji Woong Yeom, Yu Min Suh, Jin Soo Suh
BACKGROUND: We aimed to compare the postoperative height of the second metatarsal head relative to the first metatarsal head using axial radiographs among 3 different commonly used osteotomy techniques: proximal chevron metatarsal osteotomy (PCMO), scarf osteotomy, and distal chevron metatarsal osteotomy (DCMO). METHODS: We retrospectively reviewed the radiographs and clinical findings of the patients with painful callosities under the second metatarsal head, complicated by hallux valgus, who underwent isolated PCMO, scarf osteotomy, or DCMO from February 2005 to January 2015...
September 22, 2016: Foot & Ankle International
Shirley Chen, Adam Fleischer, Craig Wirt, Richmond Robinson, Carolina Barbosa, Arezou Amidi, Robert Joseph
INTRODUCTION AND OBJECTIVES: The purpose of this study was to determine whether some foot/ankle surgeries would benefit from routine use of low molecular weight heparin (LMWH) as postoperative DVT prophylaxis. METHODS: We conducted a formal cost-effectiveness analysis using a decision analytic tree to represent the risk of complications under a scenario of no prophylaxis and a scenario of routine LMWH prophylaxis for 4 weeks. The two scenarios were compared for five procedures: 1) Achilles tendon repair (ATR), 2) total ankle replacement (TAR), 3) hallux valgus surgery (HVS), 4) hindfoot arthrodesis (HA), and 5) ankle fracture surgery (AFS)...
September 2016: Journal of the American Podiatric Medical Association
Sharmila Venkatesan, Martijn G M Schotanus, Roel P M Hendrickx
The Manchester-Oxford Foot questionnaire (MOxFQ) is a 16-item patient reported outcome measure developed and validated for use in clinical trials involving foot surgery. The purpose of the present study was to evaluate the psychometric properties of the Dutch translation of the MOxFQ in patients who had undergone a hallux valgus correction. A total of 79 patients who had undergone hallux valgus correction completed the Medical Outcomes Study short-form 36-item questionnaire (SF-36) and MOxFQ before and after surgery...
September 9, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Caitlin K Gribbin, Scott J Ellis, Joseph Nguyen, Emilie Williamson, Elizabeth A Cody
BACKGROUND: Hallux valgus is frequently associated with additional forefoot pathologies, including hammertoes and midfoot osteoarthritis (OA). However, the pathogenesis of these concurrent pathologies remains to be elucidated. We sought to determine whether there is a relationship between demographic and radiographic parameters and the incidence of secondary pathologies in the setting of a bunion, with an emphasis on second tarsometatarsal (TMT) OA and hammertoes. METHODS: A total of 153 patients (172 feet) who underwent reconstruction for hallux valgus were divided into 3 groups: (1) bunion only (61 patients), (2) bunion with hammertoe without second TMT joint OA (78 patients), and (3) bunion with second TMT joint OA (14 patients)...
September 12, 2016: Foot & Ankle International
Barry Rose, Kumar Kunasingam, Tristan Barton, James Walsh, Karen Fogarty, Andrew Wines
: Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. One hundred patients with hallux valgus and rigidus requiring surgical correction were recruited and randomized to receive a postoperative continuous infusion at the ankle of normal saline or ropivacaine for 24 hours...
September 9, 2016: Foot & Ankle Specialist
Toshinori Kurashige, Seiichi Suzuki
: Some authors reported the results from percutaneous distal metatarsal osteotomy for hallux valgus recently. On the other hand, there are few reports of percutaneous proximal metatarsal osteotomy. The purpose of the present study was to evaluate the radiographic results of percutaneous proximal closing wedge osteotomy with Akin osteotomy for correction of severe hallux valgus and increasing longitudinal arch height. Consecutive 17 feet (mean age = 70.8 years) were investigated. The mean follow-up was 22 months...
September 9, 2016: Foot & Ankle Specialist
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
Mindi Feilmeier, Paul Dayton, Merrell Kauwe, Andrea Cifaldi, Britney Roberts, Hannah Johnk, Rachel Reimer
: Intercuneiform instability has been recognized as a potential cause of hallux valgus recurrence following tarsal-metatarsal joint (TMTJ) fusion. Recommendations have been made for additional screw placement between the metatarsals and/or the cuneiforms to improve stability. The screw orientation that provides the best stability has not been documented. Twelve cadavers with the first TMTJ fixated were used for testing. Using a consistent force application of 15 pounds in both the transverse and coronal planes, we measured the change in intermetatarsal angle on radiographs...
September 5, 2016: Foot & Ankle Specialist
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