Current concepts review of hallux valgus

Kakwani, Mehak; Kakwani, Rajesh

doi:10.1016/j.jajs.2021.04.006

Cited by 5 publications

(7 citation statements)

References 83 publications

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“…According to Domiziano T et al, conservative therapy can only treat symptoms because no nonsurgical treatment methods can permanently rectify hallux valgus deformity and it is impossible to reverse the deformity's irreversible cartilage, bone, and soft tissue adaption [2]. To treat acute, episodic inflammatory processes, nonsteroidal antiinflammatory medications, and physical therapy can be used.…”

Section: Discussionmentioning

confidence: 99%

“…Hallux valgus is described as a lateral deviation of the great toe at the metatarsophalangeal joint. The etiology of hallux valgus remains unclear, many factors have been identified that cause hallux valgus such as genetics, tight footwear, hyperlaxity, pes planus, and a tight Achilles tendon [2]. Patients with hallux valgus can develop secondary hammertoe deformities of the lesser toes.…”

Section: Introductionmentioning

confidence: 99%

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Minimal Implant Fixation in Correction Deformity of Hallux Valgus and Hammer Toe with Lapidus Procedure and Distal Chevron Technique – A Case Report

Sari,

Subawa

2024

International Journal of Scientific Advances

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Introduction: Hallux valgus is a complex positional deformity that leads to altered joint mechanics, dysfunction, and progressive pain often at the medial eminence of the first metatarsophalangeal (MTP) joint. Hammertoe is described as partial or complete dislocations of the proximal interphalangeal joints. This disease is usually asymptomatic, however, in some cases, it can cause pain and may cause discomfort when wearing footwear. Surgical treatment is routinely recommended for the severe hallux vagus and hammer toe deformity that is refractory to conservative care. In this case, clinical and minimally invasive surgery for reconstruction of deformity correction of the hallux vagus and hammer toe are described. Case illustration: We reported a 54-year-old female presented with a 4-year history of worsening pain and deformity to the left great toe which was initially aggravated by wearing tight shoes while the patient was working. She also complained of pain in the second toe of the left foot since 3 years ago, the pain felt worse when doing activities using footwear. The patient said that initially the left big toe was bent outwards so the second toe also became bent. Clinically she has hallux vagus and mallet toe. On a plain radiograph, her deformity was classified as severe with a Hallux Vagus Angle (HVA) of 46 degrees, and an intermetatarsal angle (IMA) of 25 degrees. She was offered surgical correction by Lapidus procedure and Chevron Procedure, the alignment was maintained with klep and screw. Post-surgical correction shows improvement and on the fifth week, the patient was allowed to full weight bearing with no immediate complication. Conclusion: Hallux Valgus is a common foot deformity but complex. It is not a single deformity but rather a range of deformities and in some cases, it can cause pain and discomfort suggesting that several factors may be responsible. More than one hundred techniques have been introduced for the correction of Hallux valgus but there is no established ideal operation. This is due to the fact that etiology and pathogenesis are not yet known certainty. This surgical procedure that was chosen in this case shows good results. Therefore, further research is needed to explore the possibility of determining factors that are common to each foot and then hopefully lead an optimal treatment protocols for Hallux valgus in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimal Implant Fixation in Correction Deformity of Hallux Valgus and Hammer Toe with Lapidus Procedure and Distal Chevron Technique – A Case Report

Sari,

Subawa

2024

International Journal of Scientific Advances

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“…Dislokacija na nivou sezamoidnog kompleksa i glave prve MT kosti rezultat je njenog pomjeranja medijalno (varizacija), pri čemu dolazi do istezanja medijalnog metatarzosezamoidnog ligamenta, a zbog istovremene valgizacije palca odvija se istezanje medijalnog kolateralnog ligamenta i pripadajućeg dijela kapsule, uz povećanje intermetatarzalnog i hallux valgus ugla. Istovremeno, na lateralnoj strani dolazi do skraćenja lateralnog metatarzosezamoidnog ligamenta a, zahvaljujući valgizaciji proksimalne falange palca, dolazi do skraćenja lateralnog kolateralnog ligamenta i pripadajućeg dijela kapsule, kao i tetive aduktora palca (slika 3) (2,16).…”

Section: Uvodunclassified

“…Sovilj M. et al Značaj mekotkivnih hirurških intervencija na distalnom dijelu stopala u liječenju hallux valgus-a. MedPodml 2023, 74(6): [14][15][16][17][18][19] Budući da su patološko-anatomske promjene na distalnim mekim tkivima prednjeg dijela stopala kod hallux valgus deformiteta degenerativne prirode i više izražene od promjena na koštanim strukturama, intervencije na ligamentarnim, kapsularnim i tetivnim strukturama neizostavan su dio hirurškog liječenja ovog deformiteta. Do sada nije utvrđen konsenzus u pogledu prirode i načina izvođenja distalnih mekotkivnih intervencija.…”

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The importance of soft tissue surgical interventions on the distal part of the foot in the treatment of hallux valgus

Sovilj,

Baščarević

2023

Medicinski podmladak

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Since pathological anatomical changes in the distal soft tissues of the front part of the foot in hallux valgus deformity are degenerative in nature and more pronounced than changes in the bony structures, interventions on ligamentous, capsular and tendinous structures are an indispensable part of its surgical treatment. A consensus has not been established regarding the nature and method of performing distal soft tissue interventions. To avoid the risk of consequent aseptic necrosis of the first metatarsal bone head in case of simultaneous osteotomy at its distal level, it is necessary that the osteotomy be performed in a safe place and the plantar and dorsal segments of this capsule must remain preserved. To avoid the occurrence of iatrogenic hallux varus deformity, lateral sesamophalangeal ligament, lateral sesamoid and associated part of the plantar aponeurosis must remain preserved. Since the deep transverse metatarsal ligament keeps the sesamoid apparatus in the anatomical position, its release should be avoided. Lateral release of adductor tendons of the thumb, lateral collateral ligament and associated part of the capsule facilitate correction of the position of the thumb with a modest contribution to the overall correction of deformity and allow access to the shortened lateral metatarsosesamoid ligament, which must be completely released, making the greatest contribution to overall correction. At the same time, the mentioned interventions are safe from the aspect of risk of possible complications, especially when performed using a special dorsal intermetatarsal approach. Reconstructive interventions on the soft tissues of the medial side of the metatarsophalangeal joint of the thumb include their tightening while stabilizing the thumb in a neutral position.

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“…Hallux valgus (HV) is a complex three-dimensional deformity usually associated with hyperextension of the hallux. Predisposing factors for HV include hereditary aspects, biomechanical compensation of the lower limb, metatarsus adductus, flat foot, foot morphology, gastrocnemius shortening, narrow shoes, and joint hyperlaxity [ 1 – 3 ]. The bifurcation or accessory tendon of the extensor hallux longus (EHL) has also been reported to be a predisposing factor for HV [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional study of the prevalence of hyperextension of the first metatarsophalangeal joint and its relationship to onycholysis in women with hallux valgus

Giménez-López,

Barrios-Pitarque

2024

BMC Musculoskelet Disord

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Background Hallux Valgus (HV) deformity is associated with misalignment in the sagittal plane that affects the first toe. However, the repercussions of the first toe hyperextension in HV have been scarcely considered. The purpose of this study was to provide evidence of the association between first-toe hyperextension and the risk of first toenail onycholysis in HV. Methods A total of 248 HV from 129 females were included. The extension of 1st MTP joint was measured while the patient was in the neutral position of the hallux using a two-branch goniometer. The classification of the HV severity stage was determined by the Manchester visual scale, and the height of the first toe in the standing position was measured using a digital meter. An interview and clinical examination were performed to collect information on the presence of onycholysis of the first toe. Results Of the 248 HV studied, 100 (40.3%) had onycholysis. A neutral extension > 30 degrees was noted in 110 (44.3%) HV. The incidence of onycholysis was higher in HV type C than in type B (p = 0.044). The probability of suffering onycholysis in the right foot was 2.3 times greater when the neutral position was higher than 30 degrees (OR = 2.3; p = 0.004). However, this was not observed in the left foot (p = 0.171). Onycholysis was more frequent in HV with more than 2 cm height of the first toe (p < 0.001). For both feet, the probability of suffering onycholysis was greater for each unit increase in hallux height (right foot OR = 9.0402, p = 0.005; left foot OR = 7.6633, p = 0.010). Conclusions The incidence of onycholysis appears to be significantly associated with HV showing more than 30º extension, and more than 2 cm height of the first toe. Height and hyperextension of the first toe together with first toenail pathology should be mandatory in the evaluation of HV.

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Current concepts review of hallux valgus

Cited by 5 publications

References 83 publications

Minimal Implant Fixation in Correction Deformity of Hallux Valgus and Hammer Toe with Lapidus Procedure and Distal Chevron Technique – A Case Report

Minimal Implant Fixation in Correction Deformity of Hallux Valgus and Hammer Toe with Lapidus Procedure and Distal Chevron Technique – A Case Report

The importance of soft tissue surgical interventions on the distal part of the foot in the treatment of hallux valgus

Cross-sectional study of the prevalence of hyperextension of the first metatarsophalangeal joint and its relationship to onycholysis in women with hallux valgus

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