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Correction method for moderate and severe degrees of hallux valgus associated with transfer metatarsalgia

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World Journal of Orthopedics 2024年第3期15卷 238-246页

作者： Amangasy Zhanaspayev Nurlan Bokembayev Marat Zhanaspayev Aidos Tlemissov Sabina Aubakirova Alexander Prokazyuk Department of Traumatology and Orthopaedics The National Scientific Center of Traumatology and Orthopaedics Named after Academician Batpenov NDAstana 010000Kazakhstan Department of Traumatology and Paediatric Surgery Non-Commercial Joint-Stock Company“Semey Medical University”Semey 071400Kazakhstan Department of Habilitation and Rehabilitation Center of Habilitation and Rehabilitation of Persons with Disabilities of the Abai RegionSemey 071400Kazakhstan Department of Anaesthesiology and Resuscitation Center of Nuclear Medicine and OncologySemey 071400Kazakhstan

BACKGROUND hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in *** associated foot pain causes impaired gait and decreases quality of *** and severe HV is a deformity that is charac-terized by the involvement of lesser rays and requires complex surgical *** this study,we attempted to develop a procedure for this *** To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot *** We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated *** method included a modified Lapidus procedure,M2M3 tarsometatarsal arthrodesis,intermetatarsal fusion of the M4 and M5 bases,and the use of an original external fixation apparatus to enhance correction ***,postoperative,and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society(AOFAS)scores were compared,and P values<0.05 were considered to indicate statistical *** The study included 28 females(93.3%)and 2 males feet(6.7%),20(66.7%)of whom had a moderate degree of HV and 10(33.3%)of whom had severe deformity.M2 and M3 metatarsalgia was observed in 21 feet,and 9 feet experienced pain only at *** mean follow-up duration was 11 *** patients had good correction of the HV angle[preoperative median,36.5 degrees,interquartile range(IQR):30-45;postoperative median,10 degrees,IQR:8.8-10;follow-up median,11.5 degrees,IQR:10-14;P<0.01].At follow-up,metatarsalgia was resolved in most patients(30 vs 5).There was a clinically negligible decrease in the corrected angles at the final follow-up,and the overall AOFAS score was significantly better(median,65 points,IQR:53.8-70;vs 80 points,IQR:75-85;P<0.01).CONCLUSION The developed me

关键词： hallux valgus Metatarsalgia Tailor’s bunion Lapidus procedure Proximal metatarsal osteotomy Splayfoot

Functional Dependence of IM and HV Angle in hallux valgus Deformity before and after Operative

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Journal of Applied Mathematics and Physics 2024年第5期12卷 1626-1646页

作者： Nenad Stojanović Mirko Sovilj Vesna Ivanišević Department of Mathematics Faculty of Philosophy University of Banja Luka Banja Luka Bosnia and Herzegovina Higher Medical School Prijedor Bosnia and Herzegovina Faculty of Medicine University of Banja Luka Banja Luka Bosnia and Hercegovina

hallux valgus is a relatively common and multifaceted complex deformity of the front part of the foot. It is the result of multiple effects of innate (endogenous) and exogenous etiological factors with different degrees of influence. The degree of hallux valgus deformity is usually assessed by radiological values of hallux valgus (HV) and intermetatarsal (IM) angles. The aim of the paper is to justify the definition of hallux valgus deformity as a function of one angle, (HVA or IMA), and then to determine the functional connection and the most suitable function equalizing the values of the angles IMA and HVA. As hallux valgus is a double angulation deformity, the analytically determined connection between the HVA and IMA angles reduces the study of the deformity to the study of function with one argument, and makes the analysis of deformity changes before and after operative treatment simpler. For the determined connections between the angles, the values of linear proportionality coefficients and regression coefficients of corresponding linear functions of analytical equalization of the value of the IM angle and the degree of deformity for a given value of the HV angle were experimentally determined. The obtained results were checked on a sample of 396 operatively treated hallux valgus deformities. The presented analytical approach and the obtained functional links of IMA and HVA enable quantitative observation of the change in the degree of deformity based on the radiologically determined value of these angles, and the established nonlinear function will be useful for evaluating the expected value of the IM angle and the degree of deformity based only on the measured value of the HV angle. .

关键词： Functional Connection of Deformity Angles Analytical Equalization of IM Angle Values hallux valgus Intermetatarsal Angle Correction of Deformity

Role of lateral soft tissues release in percutaneous hallux valgus correction:A medium term retrospective study

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World Journal of Orthopedics 2023年第12期14卷 843-852页

作者： Fabio Zanchini Ottorino Catani Fabrizio Sergio Alessia Boemio Angelo Sieczak Davide Piscopo Salvatore Risitano Gabriele Colò Federico Fusini Division of Orthopaedics and Traumatology Multidisciplinary Department of Medical-Surgical and Dental SpecialtiesClinical OrthopeadicsUniversity of Campania“Luigi Vanvitelli”Naples 80138Italy Department of Foot Surgery Casa di cura Santa MariaSanta Maria Capua Vetere 81055Italy Department of Foot an Ankle Surgery Casa di cura Santa MariaSanta Maria Capua Vetere 81055Italy Multidisciplinary Department of Medical-Surgical and Dental Specialties Clinical OrthopeadicsAOU Luigi VanvitelliNapoli 80138Italy Clinical Orthopeadics University of Campania Luigi VanvitelliNaples 80138Italy Department of Orthopaedic and Traumatology Orthopaedic and Trauma CentreCittàdella Salute e della Scienza di TorinoTurin 10126Italy Department of Orthopaedics and Traumatology Regional Center for Joint ArthroplastyASO AlessandriaAlessandria 15121Italy Department of Orthopaedic and Traumatology Regina Montis Regalis HospitalCuneo 12084Italy

BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone,the synthesis or not of the metatarsal head,the possible association with lateral soft tissues release(LSTR)and osteotomy of the base of the first *** To evaluate the role of LSTR on percutaneous HV correction,evaluating functional and radiographical *** From January 2012 to May 2016 a total of 396 patients with mild to moderate symptomatic HV treated with the MIS technique were included in this retrospective *** technique provides no internal fixation(WOS).Patients were divided into the LSTR group and no LSTR group(LSTR N).This surgical procedure(LSTR)was reserved for insufficient HV angle(HVA)correction during fluoroscopic *** were evaluated at each follow-up by two other authors after appropriate training by senior authors(first practitioners).Clinical evaluation was performed before surgery,6 mo after surgery,and 48 mo *** Orthopaedic Foot and Ankle Society(AOFAS)and visual analog scale(VAS)score was used to evaluate pain and function,and complications were *** addition,the incidence of relapses and the degree of joint range of motion(ROM)with the association with the LSTR(capsule,adductor tendon,phalanx-sesamoid ligament,and the deep transverse metatarsal ligament)were *** parameters included HVA and intermetatarsal angle(IMA).Patient satisfaction was *** t-test and Fisher exact test were used to assess statistical *** From our study it is clear that no differences in term of HVA,VAS,IMA correction,rate of complications,and AOFAS score were found between groups,while a significant improvement of the same variables was found in each group between pre and postoperative values.A significant improvement in ROM at 6 mo(P=0.018)and 48 mo(P=0.02)of

关键词： hallux valgus Percutaneous distal osteotomy Lateral release Minimally invasive surgery Without ostheosynthesis Range of motion

hallux valgus deformity treated with the extensor hallucis longus tendon transfer by dynamic correction

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Chinese Medical Journal 2010年第21期123卷 3034-3039页

作者： ZHANG Feng-qi WANG Hui-juan ZHANG Qi LIU Ya-ling ZHANG Ying-ze Department of Foot and Ankle Surgery the Third Hospital Hebei Medical University Shijiazhuang Hebei 050051 China Department of Dermatology the Third Hospital Hebei Medical University Shijiazhuang Hebei 050051 China Orthopaedic Center for Traumatic Emergency Treatment the Third Hospital Hebei Medical University Shijiazhuang Hebei 050051 China Department of Histology and Embryology Hebei Medical University Shijiazhuang Hebei 050017 China

Background Recurrence of hallux valgus is considered to be the most common problem experienced *** designed and caried out operations to correct hallux valgus by transferring the extensor hallucis longus （EHL） tendon to reduce the likelihood of *** Twenty-five patients （38 feet） with the average age of （46.3±12.3）（range, 22 to 60） years underwent the operation. The American Orthopaedic Foot and Ankle Society score and weight-bearing radiographs of the foot were applied to assess the feet pre- and postoperatively with a mean duration of follow-up of （38.2±3.2） months. The surgical procedure includes the release of the distal soft tissues, excision of the medial eminence, plication of the medial part of the capsule, and transfer of the EHL tendon, and reconstructing its *** At follow-up, 35 feet （23 patients, 85%） were free from pain at the first metatarsophalangeal （MTP） joint. In three feet （two patients）, the pain was alleviated but persisted. The mean hallux valgus angle decreased significantly from a preoperative 38.3°±8.0° to 7.3°±2.0° at the time of the most recent follow-up （P 〈0.0001）, and the mean intermetatarsal （IM） angle decreased significantly from preoperative 12.5°±3.4° to postoperative 6.5°±2.4° （P 〈0.0001）. The mean score according to the American Orthopaedic Foot and Ankle Society had increased from 46.5 to 84.8 points （P 〈0.0001）.Conclusions hallux valgus can be corrected by transferring the EHL tendon medially and reconstructing its *** technique can achieve stress balance of metatarsophalangeal joints and therefore prevent the recurrence of hallux valgus.

关键词： hallux valgus tendon transfer orthopedic procedures

A reappraisal of the relationship between metatarsus adductus and hallux valgus

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Chinese Medical Journal 2014年第11期127卷 2067-2072页

作者： Chen Li Wang Chen Wang Xu Huang Jiazhang Zhang Chao Zhang Yijun Ma Xin Department of Orthopedics Huashan Hospital Fudan University Shanghai 200040 China

Background A causal link between the metatarsus adductus and hallux valgus is not *** 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 *** The 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 *** including the hallux valgus angle （HVA）,the intermetatarsal angle （IMA）,the Kilmartin angle （KA）,the tibial sesamoid position （TSP）,and metatarsus adductus angle were *** metatarsus adductus angle is defined by Sgarlato＇s angle （SMA） and Engel＇s angle （EMA） *** The 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 *** this group,the correlation between HVA and metatarsus adductus angle was negative （r=-0.472,P=0.027）.Conclusions EMA and SMA defined metatarsus adductus by different deformity *** adductus configurations in that the apex of the deformity lay in either the base of metatarsals or *** respectively correlate positively or negatively to the HVA.

关键词： metatarsus adductus hallux valgus sesamoid bones radiological measurements

Classification of hallux valgus Using Conjugated Deformity

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Journal of Applied Mathematics and Physics 2023年第6期11卷 1615-1633页

作者： Nenad Stojanović Mirko Sovilj Vesna Ivanišević Draško Vasović Department of Mathematics Faculty of Agriculture University of Banja Luka Banja Luka Bosnia and Hercegovina Faculty of Medicine University of Belgrade Belgrade Serbia Faculty of Medicine University of Banja Luka Banja Luka Bosnia and Hercegovina Institute for Orthopedic Surgery “Banjica” Belgrade Serbia

hallux valgus is a complex deformity of the forefoot. It is the result of multiple effects of endogenous and exogenous etiological factors with different degrees of influence. The degree of hallux valgus deformity was assessed by radiological values of hallux valgus (HVA) and intermetatarsal (IMA) angle. Thus, each hallux valgus deformity corresponds to a pair (HVA, IMA) of hallux valgus angle (HVA) and intermetatarsal angle (IMA) values in the plane of the deformity. The intensity of the point position vector S (HVA, IMA) in the deformation plane determined by the relation represents the absolute (conjugate) value of the power deformities. The goal of the article is to explain the advantage of the definition of the degree of hallux valgus deformity using its absolute (conjugate) value, and then to show that the degree of deformity defined in this way enables a better classification of deformities for all values of the HVA and IMA angles. Furthermore, in this article, applying the definition of conjugate deformity, analytical expressions were constructed for the assessment of the average value of deformity correction after operative treatment, as well as the error assessment of deformity correction after operative treatment. All obtained results were checked on a sample of 396 operatively treated feet.

关键词： Conjugated Deformity hallux valgus Classification Deformity Correction

The Radiological Outcome of Surgical Correction of hallux valgus with Combined Scarf and Akin Osteotomies

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Open Journal of Orthopedics 2023年第3期13卷 84-96页

作者： Sami Nogdallah Mohamed Alhassan Osman Montaser Fatooh Alaa Mohamed Mohamed Khairy Hozifa Mohammed Ali Abd-Elmaged Osama Gamal Nubi Orthopedics Surgery Department Alneelain University Khartoum Sudan Bashaer Teaching Hospital Khartoum Sudan Orthopaedic Registrar Sudan Medical Specialization Board Khartoum Sudan Orthopedics Surgery Department Alzaiem Alazhari University Khartoum Sudan Bashaer University Hospital MBBS Al Neelan University Khartoum Sudan

Background: hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.

关键词： hallux valgus Scarf Osteotomy Akin Osteotomy valgus Angle Intermetatarsal Angle

Metallic resurfacing hemiarthroplasty of the first metatarsophalangeal joint combined with first metatarsal osteotomy for the treatment of hallux rigidus with hallux valgus in China

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Chinese Medical Journal 2014年第11期127卷 2186-2188页

作者： Jin Kaiji Wang Yuanli Fu Zhongguo An Shuai Xu Hailin Jiang Baoguo Department of Orthopedics & Trauma Peking University People's Hospital Beijing 100044 China Department of Orthopedics Peking Longfu Hospital Beijing 100010 China

hallux rigidus occurs mainly at the first metatarsophalangeal （MTP） joint,causing localized pain and degenerative arthritis.1 This condition frequently occurs together with hallux valgus and is difficult to *** hallux rigidus affecting only one joint,the treatment choices include articular debridement,resection arthroplasty,prosthetic arthroplasty,and arthrodesis,depending on the degree of arthritis.

关键词： hallux rigidus hallux valgus metallic resurfacing hemiarthroplasty metatarsophalangeal joint

Treatment of Mild to Moderate hallux valgus, Percutaneous Osteotomy versus Distal Chevron Osteotomy

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Open Journal of Orthopedics 2016年第6期6卷 150-157页

作者： Ahmed Mohamed Ahmed Othman Islam Hassan Ali Hegazy Department of Orthopedic Surgery Faculty of Medicine El-Minia University El-Minia Egypt Department of Orthopedic Surgery Faculty of Medicine Benha University Benha Egypt

Objective: The aim of this study was to compare two different surgical techniques for treating mild to moderate cases of hallux valgus. Methods: Forty-one patients (58 feet) with mild to moderate hallux valgus were treated by either percutaneous technique (n = 24) patients (33 feet) or by distal chevron osteotomy (n = 17) (25 feet). Results: In the percutaneous group, after a mean follow up of 49.36 months, the mean correction of hallux valgus angle (HV) was 26.69°in the intermetatarsal angle, average correction was 9.45°. The mean improvement of American Orthopedic Foot and Ankle Score (AOFAS) was 46.45 points. In the chevron osteotomy group, the mean follow up of 51.56 months, the mean correction of hallux valgus angle was 26.78°in the intermetatarsal angle, average correction was 9°. The mean improvement of AOFAS was 44.76 points. Conclusion: Both techniques gave satisfactory results. However, the percutaneous technique is safer than the distal chevron osteotomy.

关键词： hallux valgus Percutaneous Technique Chevron Osteotomy AOFAS