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Associated deformities and hypermobility in hallux valgus: an investigation with weightbearing radiographs.
Foot Ankle Int. 2004 Apr; 25(4):251-5.FA

Abstract

BACKGROUND

Hallux valgus has been reported to recur after surgical correction in patients subsequently diagnosed with hypermobility of the first ray, pronation of the foot, and pes planovalgus. An objective means of assessing the foot for these deformities preoperatively may avert a poor outcome. This investigation evaluated the efficacy of full-length weightbearing radiographs to recognize associated deformities in patients with hallux valgus before surgery.

METHODS

This study compared five parameters from anteroposterior and four parameters from lateral weightbearing pedal radiographs of patients with moderate to severe hallux valgus to a control group to identify differences in the alignment of the midfoot and the first metatarsal-medial cuneiform joint. An examination for clinical evidence of hypermobility was also performed on both groups.

RESULTS

The hallux valgus group demonstrated increased abduction and dorsiflexion of the midfoot. The mean talonavicular coverage angle and lateral talo-first metatarsal angle of this group was greater than the mean values for the controls. Radiographic evaluation also revealed differences in the alignment of the first metatarsal-medial cuneiform joint in the sagittal plane. The hallux valgus group possessed a mean of 2 mm of dorsal translation and 2 degrees of dorsiflexion at this joint compared to the controls.

CONCLUSIONS

Weightbearing radiographs permit the recognition of associated malalignments of the foot in patients with hallux valgus. The comparisons performed in this study identified deformities consistent with pes planovalgus and hypermobility of the first ray in patients with moderate to severe hallux valgus. The results of our study support a recommendation for a thorough evaluation of full-length, biplanar weightbearing radiographs via the measurement of midfoot and first ray alignment for concomitant deformities of the foot in patients with hallux valgus.

Authors+Show Affiliations

University of Chicago Medical Center, Section of Orthopaedic Surgery and Rehabilitation Medicine, 5841 South Maryland Avenue, MC 3079, Chicago, IL 60637, USA.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15132934

Citation

King, David M., and Brian C. Toolan. "Associated Deformities and Hypermobility in Hallux Valgus: an Investigation With Weightbearing Radiographs." Foot & Ankle International, vol. 25, no. 4, 2004, pp. 251-5.
King DM, Toolan BC. Associated deformities and hypermobility in hallux valgus: an investigation with weightbearing radiographs. Foot Ankle Int. 2004;25(4):251-5.
King, D. M., & Toolan, B. C. (2004). Associated deformities and hypermobility in hallux valgus: an investigation with weightbearing radiographs. Foot & Ankle International, 25(4), 251-5.
King DM, Toolan BC. Associated Deformities and Hypermobility in Hallux Valgus: an Investigation With Weightbearing Radiographs. Foot Ankle Int. 2004;25(4):251-5. PubMed PMID: 15132934.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associated deformities and hypermobility in hallux valgus: an investigation with weightbearing radiographs. AU - King,David M, AU - Toolan,Brian C, PY - 2004/5/11/pubmed PY - 2004/6/29/medline PY - 2004/5/11/entrez SP - 251 EP - 5 JF - Foot & ankle international JO - Foot Ankle Int VL - 25 IS - 4 N2 - BACKGROUND: Hallux valgus has been reported to recur after surgical correction in patients subsequently diagnosed with hypermobility of the first ray, pronation of the foot, and pes planovalgus. An objective means of assessing the foot for these deformities preoperatively may avert a poor outcome. This investigation evaluated the efficacy of full-length weightbearing radiographs to recognize associated deformities in patients with hallux valgus before surgery. METHODS: This study compared five parameters from anteroposterior and four parameters from lateral weightbearing pedal radiographs of patients with moderate to severe hallux valgus to a control group to identify differences in the alignment of the midfoot and the first metatarsal-medial cuneiform joint. An examination for clinical evidence of hypermobility was also performed on both groups. RESULTS: The hallux valgus group demonstrated increased abduction and dorsiflexion of the midfoot. The mean talonavicular coverage angle and lateral talo-first metatarsal angle of this group was greater than the mean values for the controls. Radiographic evaluation also revealed differences in the alignment of the first metatarsal-medial cuneiform joint in the sagittal plane. The hallux valgus group possessed a mean of 2 mm of dorsal translation and 2 degrees of dorsiflexion at this joint compared to the controls. CONCLUSIONS: Weightbearing radiographs permit the recognition of associated malalignments of the foot in patients with hallux valgus. The comparisons performed in this study identified deformities consistent with pes planovalgus and hypermobility of the first ray in patients with moderate to severe hallux valgus. The results of our study support a recommendation for a thorough evaluation of full-length, biplanar weightbearing radiographs via the measurement of midfoot and first ray alignment for concomitant deformities of the foot in patients with hallux valgus. SN - 1071-1007 UR - https://www.unboundmedicine.com/medline/citation/15132934/Associated_deformities_and_hypermobility_in_hallux_valgus:_an_investigation_with_weightbearing_radiographs_ L2 - https://journals.sagepub.com/doi/10.1177/107110070402500410?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -