• 대한족부족관절학회지
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• 제17권4호
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• pp.272-276
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• 2013

Purpose: Recurrence is one of the most common complications after primary correction for hallux valgus deformities. The purpose of this study was to evaluate the usefulness of Scarf osteotomy with axial decompression in the treatment of recurrent hallux valgus. Materials and Methods: From April 2006 to April 2011, 14 cases (12 patients) of recurrent hallux valgus were managed with shortening Scarf osteotomy. Preoperative and postoperative radiographs were reviewed for the measurement of the hallux valgus angle (HVA), intermetatarsal angle (IMA), and the amount of the $1^{st}$ metatarsal shortening. Clinical outcomes including the visual analogue scale (VAS), the AOFAS score, and the range of motion [ROM] of the 1st metatarsophalangeal (MTP) joint were evaluated. Results: The mean HVA decreased from 27.9 degrees to 5.2 and the mean IMA decreased from 12.9 to 3.4. The mean VAS improved from 5.3 to 0.3 and the mean AOFAS score improved from 41 to 90. The mean amount of the 1st metatarsal shortening was 3.4 mm (2-5). The mean ROM of the $1^{st}$ MTP joint improved from 22 degrees (15-35) to 68 (55-75). Conclusion: Scarf osteotomy associated with axial decompression can be a useful revision procedure for the treatment of recurrent hallux valgus deformity.

• PNF and Movement
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• 제18권1호
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• pp.97-106
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• 2020

Purpose: This study aimed to determine the most effective way to facilitate the abductor hallucis muscle during PNF leg pattern-emphasized hallux abduction. Methods: The study recruited 18 healthy adults. All participants agreed voluntarily to take part in the study following an explanations of its purpose and procedures. They randomly performed the PNF leg pattern-emphasized hallux abduction variations in a hook-lying or sitting position. Activation of the abductor hallucis (AbH), adductor hallucis (AdH), extensor hallucis longus (EHL), and tibialis anterior (TA) muscles, and the ratio of AbH/AdH, were measured during PNF exercises using electromyography. One-way repeated ANOVA was used to compare the activation of foot intrinsic and extrinsic muscles during the four PNF exercises. Results: PNF leg pattern-emphasized hallux abduction using normal timing was significantly higher in TA compared to PNF leg pattern-emphasized hallux abduction using timing for emphasis, regardless of the starting position. The PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position was significantly higher in AbH than in other exercises. Although there was no statistically significant difference in the ratio of AbH/AdH, it was higher in the hook-lying position. Conclusion: PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position can be recommended as a method to optimize the activation of AbH and the ratio of AbH/AdH.

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.479-483
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• 2018

Background: We developed a modified proximal scarf osteotomy technique for moderate to severe hallux valgus in an attempt to obtain better correction of the deformity. In addition, we compared the clinical and radiographic results of this modified technique with those of the classic scarf osteotomy reported in other studies. Methods: Between December 2004 and July 2009, 44 cases of modified proximal scarf osteotomy was performed in 35 patients with moderate hallux valgus. The American Orthopedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score, range of motion of the first metatarsophalangeal joint, and radiographic results were evaluated. Results: The mean hallux valgus angle and the mean first intermetatarsal angle improved from an average of $32.2^{\circ}$ and $14.3^{\circ}$, respectively, to an average of $12.5^{\circ}$ and $8.6^{\circ}$, respectively. The distal metatarsal articular angle improved from an average of $18.7^{\circ}$ to $12.4^{\circ}$. The preoperative mean AOFAS and VAS scores were 47 points and 7 points, respectively, which improved to 86 points and 1 point, respectively, at the final follow-up. Limited range of motion occurred in two cases postoperatively. The height of the first metatarsal-cuneiform joint, which was an average of 15.9 mm preoperatively, did not change. The first metatarsal-talus angle increased from an average of $4.1^{\circ}$ to $7.1^{\circ}$. Conclusions: The modified proximal scarf osteotomy for the treatment of moderate hallux valgus showed similar results with the classic scarf osteotomy with regard to changes in the first intermetatarsal angle and postoperative satisfaction. Therefore, we suggest the modified proximal scarf osteotomy be considered as well as other proximal osteotomy in the treatment of moderate to severe hallux valgus.

• PNF and Movement
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• 제22권2호
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• pp.243-255
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• 2024

Purpose: Although foot muscle imbalance has been confirmed in patients with hallux valgus deformity, there is insufficient information on how corrective taping affects muscle activity and contraction rate of the foot muscles. The purpose of this study was to confirm the effectiveness of Mulligan taping as a treatment method for hallux valgus deformity by examining changes in muscle activity and contraction rate when Mulligan taping with inelastic tape was applied to these patients. Methods: Thirty-two patients with hallux valgus deformity were randomly divided into two groups, experimental and control. In the experimental group, Mulligan taping with inelastic tape was applied to correct the hallux valgus angle of the big toe, and in the control group, placebo taping was performed in which inelastic tape was applied in a straight line without modifying the angle of the big toe. Muscle activity and muscle contraction rate were measured before and after the intervention, and changes were compared and analyzed. Results: In the experimental group where Mulligan taping was applied, the muscle activity and muscle contraction rate of the abductor hallucis muscle significantly increased after the intervention (P < 0.05). On the other hand, the muscle activity and muscle contraction rate of the adductor hallucis muscle and tibialis posterior muscle significantly decreased (P < 0.05). There was no significant difference in muscle activity and muscle contraction rate in the control group, where placebo taping was applied (P > 0.05). Conclusion: Mulligan taping significantly changed muscle activity and contraction rates compared to placebo taping. By correcting the position of the big toe, the activity and contraction rate of the abductor hallucis muscle increased, while the activity and contraction rate of the adductor hallucis muscle and tibialis posterior muscle decreased. Therefore, Mulligan taping is considered an intervention that can prevent symptom worsening and enhance foot function by improving muscle imbalance in patients with hallux valgus deformity.

• 대한족부족관절학회지
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• 제23권4호
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• pp.159-165
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• 2019

Purpose: This study investigated the recurrence rate after performing hallux valgus correction using scarf and Akin osteotomy, and also identified the correlation and cut-off values of both the preoperative and postoperative radiographic parameters as risk factors for the recurrence of hallux valgus. Materials and Methods: We reviewed 87 hallux valgus patients (122 feet) who received scarf and Akin osteotomy from January 2007 to August 2015. The clinical outcomes were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. The radiological outcome measures included the hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) as determined on the serial weight bearing radiographs. Recurrence was defined as more than 20 degrees of HVA noted on the final follow-up radiograph. Those radiological factors associated with recurrence were evaluated and analyzed. Results: The mean follow-up duration was 20.6 months (12.0~46.5 months) and the mean age was 44 years (13~80 years). The VAS and AOFAS scores were significantly improved at the time of the final follow-up (7.0 to 2.0, p<0.001; 78.0 to 92.0, p<0.001; respectively). Significant corrections in the HVA, IMA, and DMAA were obtained (p<0.001). Eleven (9.0%: 11/122) cases experienced recurrent hallux valgus deformity. The postoperative IMA, DMAA and HVA showed significant moderate to strong correlation with HVA at the final follow-up (Pearson correlation coefficient: 0.44, 0.70, and 0.88, respectively; p<0.001). Postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees showed statistically significant correlation with radiological recurrence at the last follow-up, and the odds ratio of each variable was high in order. Conclusion: Our radiographic results indicated that postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees can be risk factors for hallux valgus recurrence. These risk factors may be helpful for modifying surgical procedures and preventing the recurrence of hallux valgus.

• 대한족부족관절학회지
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• 제27권4호
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• pp.123-130
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• 2023

Purpose: "Hallux valgus" is a common disease encountered in clinical practice and is accompanied by foot deformities. Conservative treatment is commonly used in the early stages of hallux valgus. On the other hand, surgical treatment often becomes necessary as the deformity progresses. Surgical treatments involve various osteotomy methods or joint fusion procedures combined with soft tissue release, and outcomes from these surgical treatments are generally favorable. This study compared two soft tissue release techniques in the hallux region. Materials and Methods: This study conducted a retrospective cohort study on 48 participants who underwent surgical treatment for hallux valgus at a single institution from March 1, 2018, to March 31, 2023. A scarf osteotomy was performed in all cases, and the "Modified Mcbride procedure" or "Trans-articular approach" was done for soft tissue release. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and the degree of subluxation of the lateral sesamoid were measured through simple foot radiographs taken before surgery and one year after surgery. Results: In the Modified Mcbride procedure group, HVA, IMA, and the sesamoid position grade decreased from 34.94° to 9.98°, 15.64° to 5.44°, and 2.47 to 0.44, respectively. In the trans-articular approach group, HVA, IMA, and the sesamoid position grade decreased from 33.42° to 7.34°, 15.06° to 6.03°, and 2.17 to 0.58, respectively. There was no significant difference in these changes between the preoperative and one-year postoperative measurements for both techniques (p-value>0.05). Conclusion: A radiological assessment of soft tissue release through the Modified Mcbride procedure and trans-articular approach in hallux valgus did not show significant differences. Therefore, both surgical techniques can be considered in the distal soft tissue release for a hallux valgus correction.

• 대한족부족관절학회지
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• 제1권1호
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• pp.11-14
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• 1997

Hallux valgus is a complex deformity which contains static subluxation of the first metatarsophalangeal joint with lateral deviation of the great toe and medial deviation of the first metatarsal bone. Among the several parameters, radiographic indices are the important ones in the choice of the treatment method. Even though, the normal values of the western peoples are already estabilished, there was no standard values for Korean who has different genetics, and cultural background, till now. So, we tried to estimate the noraml values of the HVA (hallux valgus angle ), IMA ( Intermetatarsal angle) and DMAA (Distal Metatarsal Articular surface Angle) in a normal adult. Fifty normal adult (each 25 male and female) were chosen and took 100 cases of foot radiograph and radiologic indices of the hallux valgus were measured. Average age at the investigation was 34.5 years old. The average HVA is $13.3^{\circ}$, IMA is $8.5^{\circ}$ and DMAA is $34.6^{\circ}$.

• 대한족부족관절학회지
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• 제7권1호
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• pp.36-40
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• 2003

Purpose: To investigate the relationship between radiographic parameters of the forefoot and plantar pressure in patients with hallux valgus. Materials and Methods: Plantar pressures of 21 patients with hallux valgus were examined with EMED-ST system. The data were compared with the parameters on the simple weightbearing dorsoplantar radiographs of the feet. The radiographic parameters that were measured were hallux valgus angle, 1-2 intermetatarsal angle, relative lengths of the metatarsals which were measured with the methods described by Maestro et al. and Okuda et al. Results: Statistically significant correlation was found between peak pressures under 2, 3 metatarsal heads and the relative lengths of 2, 3 metatarsals which were measured with the method described by Maestro et al. However they could explain only 13% of the pressures under the 2, 3 metatarsal heads by multivariate analysis. Conclusion: These results suggest that we cannot predict the plantar pressures under the foot with the parameters on the simple weightbearing dorsoplantar radiographs of the feet.

• 대한족부족관절학회지
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• 제16권2호
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• pp.135-139
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• 2012

The interphalangeal joint (IPJ) of the hallux has received little attention compared with the first metatarsophalangeal joint. But, the hallucal IPJ has several disorders such intra-articular fractures, dorsal dislocation, alignment disorder, and inflammatory or degenerative arthritis. Among these disorders septic arthritis of the IPJ of the hallux is rare. We report a case of sepsis of the hallucal IPJ and adjacent underlying osteomyelitis without neuropathic problem and was performed through infected soft tissue and osseous debridement, temporary antibiotic-impregnated cement spacer, and delayed intercalary allogenic fibular bone graft with K-wire fixation.

• 대한족부족관절학회지
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• 제17권3호
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• pp.239-242
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• 2013

A sesamoid bone can occasionally be found under the interphalangeal joint of the hallux. These had anatomical variants and usually remain asymptomatic, it is uncommon for symptomatic cases of painful plantar keratoses or irreducible dislocation of interphalangeal joint of the hallux with incarcerated sesamoid. While the latter has a few cases, the former has not reported in Korea. We experienced a rare case of intractable plantar keratoses due to interphalangeal sesamoid bone of the hallux which may reqire excision.