Establishment and Validation of a Predictive Nomogram for Hallux Valgus with Pain Under the Second Metatarsal

Abstract

To investigate the risk factors for hallux valgus complicated with pain under the second metatarsal and construct an effective model and method for predicting hallux valgus complicated with pain under the second metatarsal based on risk factors. Methods: A total of 545 patients with hallux valgus who were admitted to our hospital were divided randomly into a training set and a validation set. The demographic characteristics, imaging indices and gait test indices of the patients were collected. The risk factors were identified by univariate and multivariate logistic regression analyses. A risk prediction model for hallux valgus with pain under the second metatarsal was established, and the area under the curve (AUC) of the receiver operating characteristic and a decision curve analysis were used for verification and identification. The value of the model was tested in the verification group. Results: Second metatarsal length, second metatarsal peak pressure, hallux valgus angle (HVA), intermetatarsal angle 1-2 (IMA1-2) and weight were the risk factors for hallux valgus complicated with pain under the second metatarsal. Based on the weighting of these seven risk factors, a prediction model was established. The AUC of the prediction model was 0.84 (95% confidence interval [CI]: 0.802~0.898, P < 0.05), and the results of a Hosmer-Lemeshow test showed a good degree of calibration (χ 2 = 10.62, P > 0.05). The internal validation of the AUC was 0.83 (95% CI: 0.737-0.885, P < 0.05). The model had obvious net benefits when the threshold probability was 10%-70%. Conclusion: Second metatarsal length, second metatarsal peak pressure, HVA, IMA1-2 and weight were the risk factors for hallux valgus combined with second metatarsal pain. The risk prediction model for hallux valgus complicated with pain under the second metatarsal based on these seven variables was proven effective.

Differences and Similarities in the Feet of Metatarsalgia Patients with and without Rheumatoid Arthritis in Remission

“…This could be explained by the fact that the first-ray pathology is comprised of the causes of metatarsal pain [69,79]. On the other hand, differences were found between the patients with and without RA, which could be due to the fact that HV is also included among the consequences of RA, although having HV does not always generate a transfer of pressure to the adjacent rays [40,73,79], with other variables being more involved in the transfer of said pressure, such as the degree of HV [40]. In this case, the patients with RA have a greater degree of HV; thus, this difference could be the reason why HV is a frequent factor in the aetiology of metatarsal pain in this population, and this greater degree could be due to the characteristics of the disease.…”