Progression of Hallux Valgus

NewsBot · Apr 2, 2017

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The progression of hallux valgus in the oriental Chinese population in Hong Kong
Kenneth Kin-Hoo Koo, Lung Fung TseEmail the author Lung Fung TseEmail the author Lung Fung Tse, Ki Wai The Foot, Article in Press

Highlights
•A retrospective study to assess whether severe hallux valgus progresses over time.
•Plain films were analysed between 2008 and 2013 in the Chinese population, Hong Kong.
•95% of cases presented with a hallux valgus angle >24°.
•Hallux valgus had statistically progressed between presentation and surgery.
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Background
Hallux valgus is the lateral deviation of the great toe at the MTPJ that has many attributing aetiologies. This study will aim to identify whether hallux valgus progresses over time in the oriental Chinese population in Hong Kong.

Methods
Patients with acquired symptomatic hallux valgus who presented to clinic between 2008 and 2013 were included. The deformities were analysed radiologically at presentation and pre-operative and angles were measured. These angles were analysed in relation to the waiting time from presentation to surgery.

Results
A sample of 43 cases from 38 patients (Mean age 63 years, range 48 to 80 years) were included. Forty-one cases had a hallux valgus angle (HVA) >24° at presentation (Mean 40.4°) and all had an intermetatarsal angle (IMA) >9°. A significant difference is seen with HVA (p = 0.040, t = −2.128) at presentation and pre-op but not IMA (p = 0.281, t = −1.095).

The average wait for surgery was 705.7 days which had shown significant correlation with progression in HVA (p = 0.031). No significant difference was seen between IMA and waiting time to surgery (p = 0.195).

Discussion
Our findings suggests severe hallux valgus deformity does progress over time in Hong Kong. Shorter waiting times for surgery could be beneficial to this population.
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NewsBot · Sep 24, 2017

Radiographic Measurements Associated with the Natural Progression of the Hallux Valgus Deformity during at Least Two Years of Follow-up
Kyoung Min Lee, MD, PhD, Seung Yeol Lee, MD, Sonya Ahmed, MD, ...
Foot & Ankle Orthopaedics September 18, 2017

Introduction/Purpose:
There have been few longitudinal studies regarding hallux valgus deformity. This retrospective study aimed to investigate the radiographic measurements associated with the progression of hallux valgus deformity during at least two years of follow-up.

Methods:
Seventy adult patients (mean age, 58.0 years; standard deviation [SD], 12.3 years; 13 males and 57 females) with hallux valgus who were followed-up for at least two years and underwent weight-bearing foot radiography were included. Radiographic measurements included the hallux valgus angle (HVA), hallux interphalangeal angle, intermetatarsal angle (IMA), metatarsus adductus angle, distal metatarsal articular angle (DMAA), tibial sesamoid position, anteroposterior (AP) talo-first metatarsal angle, and lateral talo-first metatarsal angle. Progression of hallux valgus deformity was defined as an increase of 5 degrees or more in the HVA during follow-up. Patients were divided into progressive and non-progressive groups. Binary logistic regression analysis was performed to identify factors that significantly affect the progression of hallux valgus deformity. The correlation between change in HVA and changes in other radiographic indices during follow-up was analyzed.

Results:
Eighteen out of 70 patients showed progression of 5 degrees or more in the HVA during the mean follow-up of 47.0 months (SD, 19.8 months). The DMAA (p=0.027) and AP talo-first metatarsal angle (p=0.034) at initial presentation were found to be significant factors affecting the progression of hallux valgus deformity. Change in the HVA during follow-up was significantly correlated with changes in the IMA (r=0.423; p=0.001) and DMAA (r=0.541; p<0.001).

Conclusion:
Special attention needs to be given to patients with pes planovalgus and increased DMAA during follow-up. Change in HVA was significantly correlated with changes in IMA and DMAA. Therefore, progression of hallux valgus deformity is considered to be closely related to the progressive instability of the first tarsometatarsal joint.
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NewsBot · Feb 13, 2018

Natural progression of radiographic indices in juvenile hallux valgus deformity
Ki Hyuk Sung et al
FAS: February 10, 2018

Highlights
•HVA was correlated with HIA, IMA, MAA, DMAA, and AP talo-first metatarsal angle.
•JHV deformity could progress with aging.
•Most of the deformity progression could occur before the age of 10 years.
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Background
This study aimed to estimate the annual change in radiographic indices for juvenile hallux valgus (JHV) and to analyze the factors that influence deformity progression.

Methods
Patients aged <15 years who had JHV and were followed up for at least 1 year were included. Hallux valgus angle (HVA), hallux interphalangeal angle, intermetatarsal angle, metatarsus adductus angle, distal metatarsal articular angle, anteroposterior talo-first metatarsal angle, and lateral talo-first metatarsal angle were evaluated. The progression rate of HVA was adjusted by multiple factors by using a linear mixed model.

Results
A total of 133 feet were included. The HVA and distal metatarsal articular angle both increased by 0.8° per year (p < 0.001 and p = 0.003, respectively). HVA increased by 1.5° per year (p < 0.001) at under the age of 10, and the HVA progression in the older patients was not statistically significant.

Conclusions
JHV deformity could progress with aging. Most deformity progression could occur before the age of 10 years.
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