Background
Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance.
Methods
Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants. Assessments were made in the clinic using body-worn sensors.
Results
Patients in the preoperative group generally demonstrated poorer static balance control compared with the other two groups. Despite similar age and body mass index, postoperative patients exhibited 29% and 63% less center of mass sway than preoperative patients during double- and single-support balance assessments, respectively (analysis of variance P =.17 and P =.14, respectively [both eyes open condition]). Overall, gait performance was similar among the groups, except for speed during gait initiation, where lower speeds were encountered in the postoperative group compared with the preoperative group (Scheffe P = .049).
Conclusions
This study provides supportive evidence regarding the benefits of corrective lower-extremity surgery on certain aspects of balance control. Patients seem to demonstrate early improvements in static balance after corrective HV surgery, whereas gait improvements may require a longer recovery time. Further research using a longitudinal study design and a larger sample size capable of assessing the long-term effects of HV surgical correction on balance and gait is probably warranted.
The purpose of this study was to prospectively compare preoperative findings on musculoskeletal ultrasound evaluation to observed intraoperative findings for patients undergoing surgical correction of plantar plate tears. Fifty consecutive patients with forefoot pain and a suspected unilateral plantar plate tear at the second metatarsophalangeal (MTP) joint were identified. The same examiner performed a 2-plane (longitudinal and transverse) musculoskeletal ultrasound on the painful second MTP joint. The contralateral second MTP joint was used for comparison. Longitudinal ultrasound images were graded as "torn" or "intact." Transverse ultrasound images were used to localize the suspected pathology. Results of the ultrasound were compared with observed intraoperative pathology. Forty-five plantar plate tears were identified intraoperatively. Longitudinal ultrasound images correctly identified 40 plantar plate tears. The longitudinal ultrasound had a sensitivity of 91.1%, a specificity of 25%, a positive predictive value of 91.1%, and a negative predictive value of 25%. Transverse ultrasound images identified 36 plantar plate tears correctly localizing only 19 tears. Musculoskeletal ultrasound has been widely used to identify and localize pathology in many soft tissue structures. Whereas the longitudinal ultrasound images were useful in identifying plantar plate tears, the same cannot be said about the ability to localize the tear on the transverse ultrasound images. Therefore, ultrasound may not be as good an imaging modality as magnetic resonance imaging for identification and localization of plantar plate pathology.
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