Plantar pressure characteristics in hallux valgus feet

Abstract

Due to the pathoanatomical changes in hallux valgus feet, the plantar flexion moment of the first metatarsophalangeal joint is reduced. Therefore, load bearing of the hallux is decreased during push-off. We assessed loading parameters in hallux valgus feet. Based on dorsal-plantar weight bearing radiographs of 61 feet, the intermetatarsal-, hallux valgus-, distal metatarsal articulationangle, and sesamoid position were evaluated. Plantar pressure assessment was performed with the emed 1 system during level walking. We found negative correlations between hallux valgus angle and peak pressure in the great toe (r ¼ À0.301, p < 0.023), the maximum force of the hallux (r ¼ À0.481, p < 0.001), and contact time of the great toe (r ¼ À0.448, p < 0.001), and positive correlations for force time integral (r ¼ 0.348, p < 0.001), contact area (r ¼ 0.307, p < 0.020), maximum force (r ¼ 0.430, p < 0.001), and peak pressure (r ¼ 0.361, p < 0.006) of the fifth metatarsal head. A positive correlation between the sesamoid and the metatarsal subluxation regarding maximum force (r ¼ 0.294, p < 0.034), and a negative correlation between the contact area of the hallux (r ¼ À0.232, p < 0.020) was shown. Depending on the severity, hallux valgus angle, and sesamoid subluxation, load shows significant lateral transmission in hallux valgus feet. Hallux valgus is a common pathologic, gradually progressive condition of the musculoskeletal system. Due to the weakness of the medial collateral ligament and capsule, the proximal phalanx drifts into valgus, and the metatarsal head drifts into varus. With increasing deviation of the first metatarsal, the medial sesamoid shifts under the metatarsal head, and the lateral sesamoid shifts into the space between the first and the second metatarsal head. As a consequence, the tendons of the extensor hallucis longus and the flexor hallucis longus are shifted laterally, becoming abductors and thereby exacerbating the deformity.

Effects of severe hallux valgus on metatarsal stress and the metatarsophalangeal loading during balanced standing: A finite element analysis

“…There is contrary evidence that HV deformity causes increased load on the lateral metatarsals [2,9]. Koller et al [10] assessed the plantar pressure of HV feet of different grades and found a positive correlation between HV grade and the peak pressure of the fifth metatarsal head. On the other hand, changes in the loading state of the inner foot are poorly explored.…”

The Use of Pedobarographic Examination to Biomechanical Evaluation of Foot and Ankle Joint in Adult - Own Experience

“…Wy ka za no wzrost si ły na ci sku, dzia ła ją cej w ob rę bie stóp pod II i III ko ścią śród sto pia, zmniej sze nie na ci sku pod pa lu chem (dla pa lu cha ko śla we go o 59,7% i dla palu cha sztyw ne go o 63,9%) oraz brak je go kon tak tu z pod ło żem [10]. Ty po wo w przy pad ku pa lu cha kośla we go stwier dza na jest la te ra li za cja ob cią żeń [11].…”

Detailed analysis of the transverse arch of hallux valgus feet with and without pain using weightbearing ultrasound imaging and precise force sensors

“…It is a progressive deformity that occurs on the level of the first toe, whose alignment is altered. In this deformity, the hallux shifts laterally and the first metatarsal shifts medially [8][9][10][11] due to the weakness of the medial collateral ligament and the capsule [10]. The first ray becomes unstable and hypermobile [6,12], the sesamoid-complex shifts [10] and the plantar flexor muscles weaken [13].…”

“…In this deformity, the hallux shifts laterally and the first metatarsal shifts medially [8][9][10][11] due to the weakness of the medial collateral ligament and the capsule [10]. The first ray becomes unstable and hypermobile [6,12], the sesamoid-complex shifts [10] and the plantar flexor muscles weaken [13]. This deformity is common in the elderly [8,14,15], as the intrinsic muscles that stabilize the alignment of the first ray weaken with age.…”

“…Pain in the metatarsals is also linked to changes in the transverse arch [3]. The transverse arch of individuals with hallux valgus can be changed as hallux valgus deformity distorts the normal alignment of the hallux and the first metatarsal [8][9][10][11] and affects the structure of the transverse arch (such as transverse arch height (TAH)) [22], and the force loading patterns in the forefoot [10,15,23,24].…”