Abstract
In hallux valgus (HV), toe pronation is frequently seen, although there may be some with no pronation.
Aims
to evaluate big toe pronation in patients with HV with a clinical and radiographic method.
Material and methods
prospective study of 40 patients with HV on the waiting list for surgical treatment. Patients were standing barefoot on a rigid platform. Digital photographs were taken in a frontal plane to obtain the nail-floor angle formed by the secant line of toenail border and a line formed by the platform edge. All patients were evaluated using the AOFAS for HV and lesser toes, if they were affected. Personal and social data were obtained from clinical interviews. Charge radiographs were used to obtain HV, intermetatarsal and PASA angles, first metatarsal rotation as well as sesamoid bones displacement. Exclusion criteria: rheumatoid arthritis and previous intervention on foot or toes. Statistical analysis were performed with a multiple lineal regression.
Results
the mean age was 57 years old, they were 31 female and 9 men, with an average AOFAS score of 49, they had a mean of 37° HV angle, 27° nail-floor angle, 20° first metatarsal rotation in about half of patients. We have found a statistical significant relation between HV and nail-floor angles (p<0,001), between sesamoid bones displacement and nail-floor angles (p<0,007), between first metatarsal rotation and HV angle (p<0,001. We found no statistically significant but strong relation between first metatarsal rotation and sesamoid bones displacement.
Conclusion
nail-floor angle is strongly related to degree of HV, displacement of sesamoid bones and rotation of the first metatarsal.
