Hallux Valgus Anatomical Alterations and Its Correlation With the Radiographic Findings

Cavalheiro, Cristina Schmitt; Arcuri, Marcel Henrique; Guil, Victor Reis; Gali, Julio Cesar

doi:10.1590/1413-785220202801226897

Cited by 9 publications

(11 citation statements)

References 21 publications

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“…The sesamoids on the head of the rst metatarsal are in dynamic balance because of pulling by two group muscles [31] . So in theory, either sesamoid dislocation could lead to hallux valgus [32][33] .In this study, it was found that the normal position of sesamoid bone (FSP) intersected with the lateral cortex of the rst metatarsal bone accounted for (52.3 ± 3.2) % of the total area of sesamoid bones. The purpose of this study was to nd a quantitative index for judging the dislocation of sesamoid bones on the rst metatarsal head.…”

Section: Correlation Between Tibial Sesamoid Bone and Hallux Valgusmentioning

confidence: 73%

Correlative Study Between the Sesamoid Bones under the Head of the First Metatarsal and the Development of Hallux Valgus Determined with Radiographs

Li¹,

Liu²,

Wang³

2021

Preprint

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Objective. To study the correlative between the sesamoid bones under the head of the first metatarsal and the development of hallux valgus determined with radiographs.Methods.The measurements were performed on the X-ray of 300 normal feet and 300 cases of hallux valgus. The following parameters were measured: hallux valgus angle(HVA); the first-second intermetatarsal angle(IMA) between the axes of the first and second metatarsal;the length of the second metatarsal（CD）;the position of tibial sesamoid(TSP ) measured the percent formed between the tibial sesamoid and the centreline of the first metatarsal;the position of fibular sesamoid(FSP) measured tangent value between fibular sesamoid bone and lateral cortex of first metatarsal bone ; the absolute distances (AB) from the centre of the tibial sesamoid to the long axis of the second metatarsal, the absolute distances (EF) from the centre of the fibular sesamoid to the long axis of the second metatarsal and the absolute distance (GH) from the centre of the tibial sesamoid to the centre of the fibular sesamoid. Then calculate the ratio of AB to CD (K1), EF to CD (K2) and GH to CD (K3). Results.HVA moderately positively correlates with TSP and moderately negatively correlates with FSP in subjects with HVA ≥ 20°. HVA and FSP are strongly negatively correlated in the hallux valgus group. Conclusion.The dislocation of sesamoid bone under the first metatarsal head is an important pathological factor leading to valgus. HVA is positively correlated with TSP and negatively correlated with FSP.

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Section: Correlation Between Tibial Sesamoid Bone and Hallux Valgusmentioning

confidence: 73%

Correlative Study Between the Sesamoid Bones under the Head of the First Metatarsal and the Development of Hallux Valgus Determined with Radiographs

Li¹,

Liu²,

Wang³

2021

Preprint

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“…Hallux valgus is characterized as a combined axial, sagittal, and coronal deformity with a malpositioning of the first metatarsophalangeal joint caused by a lateral deviation of the great toe and a medial deviation of the first metatarsal (Cavalheiro et al 2020; Haines & McDougall 1954; Perera et al 2011). Often, the steps leading to development of HV can occur alongside each other, and are influenced by both intrinsic and extrinsic factors such as genetics, age, metatarsal morphology, and footwear (Perera et al 2011).…”

Section: Discussionmentioning

confidence: 99%

Symmetry of bilateral hallux valgus deformity: A radiographic study

et al. 2021

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Hallux valgus (HV) is a common anatomical deformity leading to pain and difficulty with footwear and mobility. Bilateral HV deformity is much more common than unilateral although it remains unclear whether the severity of deformity is equal between feet. The objective was to investigate the severity and symmetry of HV in patients with bilateral symptomatic deformity presenting for surgery. Weight‐bearing radiographs of patients presenting with symptomatic bilateral HV were reviewed. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured and classified as mild, moderate, or severe. Left‐to‐right comparison was undertaken to assess whether the degree of deformity was similar for each foot. The relationship between age, HVA, and IMA was also assessed. Between July 2014 and June 2020, 322 ft (161 patients with bilateral deformity) underwent corrective HV surgery. Of those, 6.8%, 64.6%, and 28.4% were classified as mild, moderate, and severe, respectively on the left side, and on the right 6.2%, 67.7%, and 26.1% were classified as mild, moderate, and severe respectively. There was no statistically significant difference between feet for either IMA (p = 0.06) or HVA (p = 0.85). There was a moderate correlation (R = 0.41, p ≤ 0.001) between HVA and IMA. There was only a ‘weak’ or ‘very weak’ correlation between age and HVA or IMA. Patients presenting for surgery with symptomatic bilateral HV have symmetrical moderate radiographic deformity at the time they present for consideration of surgical intervention.

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“…As the insertion of AH, which is expected to strongly resist the valgus of the proximal phalanx and support the medial capsule of the joint in a normal individual, is displaced plantar, the resistance function of this muscle against valgus becomes less e cient [11,54,60]. The placement of the EHL, EHB and FHL tendons relative to the axes of MTPJ shifts laterally as a result of the lateral deviation of the hallux, and it is suggested that this new course of the tendons may increase the severity of the deformity [9,12,34,46]. Although associating these anatomical changes with the degree of radiographic deformity may be important in surgical planning [9], the literature on morphometric de nitions and analysis of positional changes in tendons is quite limited.…”

Section: Introductionmentioning

confidence: 99%

“…The placement of the EHL, EHB and FHL tendons relative to the axes of MTPJ shifts laterally as a result of the lateral deviation of the hallux, and it is suggested that this new course of the tendons may increase the severity of the deformity [9,12,34,46]. Although associating these anatomical changes with the degree of radiographic deformity may be important in surgical planning [9], the literature on morphometric de nitions and analysis of positional changes in tendons is quite limited.…”

Section: Introductionmentioning

confidence: 99%

“…Since the moment arm of the extensor and exor muscles is turned laterally, these muscles are stated to increase the lateral angulation of the hallux (bowstring at the MTPJ) and become an adduction force on the hallux. These changes are also associated with the clinical severity of HV [9,11,12,20,31,34,46,51,54,56]. Eustace et al (1996) showed that the position of the AH tendon shifted smarkedly plantarward in the HV and they porposed that the level of displacement is related to the hallux valgus angle (HVA) and clinical severity of the HV deformity [20].…”

Section: Introductionmentioning

confidence: 99%

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Positional and dimensional relation of tendons around the first metatarsal bone with hallux valgus

2022

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It was aimed to reveal whether the positions and dimensions of the extrinsic and intrinsic muscle tendons related to the hallux around the rst metatarsal bone are affected by the severity of hallux valgus (HV) and whether tendon positional changes and tendon sizes affect each other.In formalin-xed 46 feet, three HV angle subgroups (normal, mild and moderate/severe ) were de ned. Width, thickness and cross sectional area (CSA) of tendons of the extensor hallucis longus (EHL) and brevis (EHB), abductor hallucis (AH) and exor hallucis longus (FHL) were measured. On the clock model created in coronal plane, positional variations of each tendon were indicated. In the moderate-severe HV group, thickness and CSA of the EHB, width and CSA of the AH were smaller, compared to mild HV. Width and CSA of the FHL were smaller in moderate/severe HV than in the normal. Regardless of HV, the width and CSA of the FHL was greater in cases where the FHL located more lateral, and the width of both FHL and AT were greater in cases where AH located more plantar.The smaller tendon size of two intrinsic (one plantar and one dorsal) and one extrinsic muscle in the moderate/severe HV group indicates that the changes re ected in the tendons are more pronounced in the case of high HV severity, and the changes are not limited to the tendons on just one side of the foot. The possible biomechanical effects of AH, FHL and EHB tendon dimensional weakness may be important when planning surgery for moderate/severe HV cases.

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Hallux Valgus Anatomical Alterations and Its Correlation With the Radiographic Findings

Cited by 9 publications

References 21 publications

Correlative Study Between the Sesamoid Bones under the Head of the First Metatarsal and the Development of Hallux Valgus Determined with Radiographs

Correlative Study Between the Sesamoid Bones under the Head of the First Metatarsal and the Development of Hallux Valgus Determined with Radiographs

Symmetry of bilateral hallux valgus deformity: A radiographic study

Positional and dimensional relation of tendons around the first metatarsal bone with hallux valgus

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