• Journal of Korean Foot and Ankle Society
• /
• v.15 no.2
• /
• pp.62-67
• /
• 2011

Purpose: The authors evaluated the differences between K-wires and Cannulated screw, plate for fixing the proximal metatarsal chevron osteotomy of moderate and severe hallux valgus. Materials and Methods: There were 62 patients (79 feetz) who were moderate and severe degree hallux valgus according to the classification of Mann. They all got the proximal chevron osteotomy when correcting the deformity. We divided the patients into 4 groups, Two K-wire fixed group as A, one cannulated screw fixed group as B. Two cannulated screw fixed group as C, Plate fixed group as D, Group A were patients (26 feet) and Group B were patients z(9 feet), Group C were patients (31 feet) and Group D were patients (13 feet). Preoperative, postoperative and follow-up hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured for each patient. ANOVA test and Student t-test were done for statistical analysis. Results: Mean follow up period was 43.8 months (range: 12~82 months). Preoperative mean IMA was $16.4{\pm}3.5$, $17.7{\pm}11.3$, $17.3{\pm}5.9$ and $16.6{\pm}2.3$ degrees in respectively group A, B, C, D. Immediate postoperative mean IMA was $5.6{\pm}3.4$, $7.3{\pm}4.4$, $7.6{\pm}4.4$ and $6.7{\pm}2.8$ degrees in respectively group A, B, C, D. The final mean IMA was $8.9{\pm}4.5$, $15.2{\pm}7.5$, $10.3{\pm}4.4$ and D $7.7{\pm}3.5$ degrees in respectively group A, B, C, D. There were significant statistical increase in final mean IMA of group B and C (p<0.05). Conclusion: The IMA was significantly increased in the group which used one or two cannulated screw for fixation on follow up, therefore more caution should be needed when using one or two cannulated screw fixation technique after proximal chevron osteotomy.

• Physical Therapy Korea
• /
• v.23 no.3
• /
• pp.21-28
• /
• 2016

Background: The toe-spread-out (TSO) exercise has been introduced as a strengthening exercise for the abductor hallucis muscle in subjects with hallux valgus. Visual biofeedback using ultrasound imaging during exercise, may increase the ability to selectively contract the abductor hallucis muscle, compared with exercise alone. Objects: The aim of this study was to investigate the effects of ultrasound imaging visual feedback during the TSO exercise with respect to its influence on the angle of the first metatarsophalangeal joint (1st MPJ) and the cross-sectional area (CSA) of the abductor hallucis muscle in subjects with hallux valgus. Methods: Twenty-five healthy young subjects with a mean average age of 22.5 years, and a standard deviation of 2.3 years, were recruited for this study. Hallux valgus was defined as an angles greater than $15^{\circ}$ angle of 1st MPJ. Goniometric measurement was used to determine the angle of 1st MPJ. In addition, an ultrasound system was used to collect the CSA of the abductor hallucis muscle in each foot. The angle of the 1st MPJ and CSA of the abductor hallucis were measured in three positions; the resting position, during TSO exercise, and during TSO exercise in conjunction with real-time ultrasound imaging feedback. All data analyzed using a repeated analysis of variance with Bonferroni correction in order to compare the dependent variables in all three positions. Statistical level of significance was set up as p<.05. Results: The angle of the 1st MPJ was noted to be significantly reduced and the CSA of the abductor hallucis to be significantly greater during TSO exercise used in conjunction with ultrasound imaging visual feedback, compared to when the values were recorded during TSO exercise alone (p<.05). Conclusion: Based on these findings, it can be concluded that the application of ultrasound imaging visual feedback during TSO exercise is more effective in contracting selectively the abductor hallucis than the use of exercise alone.

• Journal of Industrial Convergence
• /
• v.19 no.6
• /
• pp.81-91
• /
• 2021

This study was conducted to investigate the effect of ankle muscle strengthening exercise using BOSU ball and taping on static and dynamic plantar pressure in patients with hallux valgus. Subjects were 26 men and women in their twenties with hallux valgus, and they were randomly assigned to a taping group (TG; n=13) and an ankle strengthening group (ASG; n=13). Each group received the appropriate intervention over a total of 4 weeks, and static and dynamic plantar pressure were measured before and after the intervention. Independent T-test was performed to examine the difference in the amount of change between groups, and paired-sample T-test was performed to determine whether the difference between the pre-post values within the group was significant. The statistical significance level was set as α=.05. As for the ratio of the total body weight of the foot (Foot), the amount of change in the ASG of the left foot was significantly decreased compared to the TG within the group (p<.05). Significantly increased (p<.05). As for the degree of pronation of the foot (MP/change ratio), the amount of change in the TG of the right foot was significantly decreased compared to the ASG (p<.05), and in the force of the foot, the TG of the left foot was the amount of change within the group compared to the ASG. was significantly increased (p<.05), and in the group-to-group change, the amount of change in TG was significantly different than that of ASG (p<.05). Therefore, it can be considered that ankle strengthening exercise using bosu ball and taping are insufficient to give effective change to patients with hallux valgus.

• Korean Journal of Applied Biomechanics
• /
• v.21 no.4
• /
• pp.397-403
• /
• 2011

The purpose of this study is to analyze the immediate effects of five toed shoes on foot structure. Subjects consisted of 26 college-aged women with pes planus. X-ray analysis of student feet were performed both barefooted and with five toed shoes. Dependent variables were hallux valgus angle, calcaneal inclination angle, 1st metatarsal declination angle, and intermetartarsal angle. Independent t-test was used for statistical analysis along with SAS. Overall, there were statistically significant changes of test subject's dependent variables when wearing five toed shoes. Specifically, the hallux valgus angle decreased, the calcaneal inclination angle and 1st metatarsal inclination angle increased, and intermetatasal angles both increased and decreased, shifting towards normal range. In every case the dependent variables shifted towards a more normal range while subjects wore five toed shoes. This study only examined the immediate corrective effects of five toed shoes on foot structure, but long-term studies are needed to understand the prolonged effects of five toed shoes on foot structure.

• Journal of Korean Foot and Ankle Society
• /
• v.4 no.2
• /
• pp.55-60
• /
• 2000

Purpose: To investigate the effect of heel elevation on the radiographic parameters of the forefoot. Materials and Methods: Forty feet in twenty-one adults were studied. Weight bearing dorsoplantar radiograph was taken with the foot on a flat surface and with the heel of the foot elevated by 5cm. Various parameters were measured and compared between the results with and without heel elevation. Result: The hallux valgus angle was increased by $5.0{\pm}3.5$ degrees with heel elevation and the change was statistically significant(p<0.01). There was no statistically significant changes in the other parameters. Conclusion: The results of this study suggest that high-heeled shoes might contribute in causing or aggravating the degrees of the hallux valgus.

• Journal of Korean Foot and Ankle Society
• /
• v.19 no.4
• /
• pp.197-200
• /
• 2015

The Akin osteotomy is a complimentary procedure in hallux valgus surgery. Surgical techniques may vary depending on the operators or fixation devices. Suture fixation, for which a removal procedure is not necessary, can often be recommended. However, there is a risk of failure due to the thin cortex of the phalanx. We describe a new technique using Ethibond suture fixation in Akin osteotomy, which can lower the risk of phalangeal cortical failure and articular cartilage irritation. First, the Akin osteotomy was performed on the proximal phalanx 5 to 6 mm distal to the first metatarsophalangeal joint. Then bone holes were drilled from dorsum to plantar parallel to osteotomy with the Kirschner wire. The final procedure involved passing the Ethibond sutures connected to a straight needle through the holes and tying it. This fixation method offers an effective and easy technique for performance of Akin osteotomy.

• Journal of Korean Foot and Ankle Society
• /
• v.21 no.3
• /
• pp.93-97
• /
• 2017

Purpose: The aim of this study was to evaluate the radiological and clinical outcomes of scarf osteotomy for hallux valgus (HV) deformity in elderly patient with osteoporosis. Materials and Methods: A total of 58 elderly patients (mean age, 72.6 years) underwent scarf osteotomy for HV deformity between 2008 and 2015. The mean follow-up period was 24.4 months. Of the 58 patients, 42 were diagnosed with osteoporosis and 16 were diagnosed as normal. The radiological and clinical outcomes were assessed preoperatively, postoperatively, and at final follow-up, including HV angle, intermetatarsal (IM) angle, American Orthopaedic Foot and Ankle Society (AOFAS) score, patient satisfaction, visual analogue scale (VAS), and complication. Results: There was no significant difference in HV angle and IM angle between the osteoporosis group and normal bone mineral densitometry group at all time points, preoperative, postoperative, and final follow-up. Moreover, there was no statistically significant difference between the two groups with respect to the AOFAS score and VAS evaluations. In the osteoporosis group, the mean HV angle improved from $36.7^{\circ}$ preoperatively to $11.3^{\circ}$ at the time of final follow-up, and the mean IM angle improved from $13.2^{\circ}$ to $5.7^{\circ}$. The mean AOFAS score improved from 52.6 preoperatively to 89.1 at the time of final follow-up. With respect to satisfaction, 83.4% of patients were very satisfied or satisfied. There were no serious complications, and all cases showed complete union at the osteotomy site. Conclusion: We believed that scarf osteotomy is a safe, effective procedure for the correction of elderly patients with osteoporosis.

• The Journal of Korean Physical Therapy
• /
• v.28 no.2
• /
• pp.124-127
• /
• 2016

Purpose: The flexor hallucis longus stretch test can determine the shortness of the flexor hallucis longus muscle by measuring the angle of extension in the first metatarsophalangeal (MTP) joint at maximum ankle dorsiflexion. Less than 30 degrees of the first MTP joint at the maximal ankle dorsiflexion indicates shortness of the flexor hallucis longus muscle. The purpose of this study was to examine the intra- and inter-reliability of the flexor hallucis longus stretch test in subjects with asymmetric hallux valgus (HV) angles. Methods: Sixteen subjects with asymmetric HV angles participated in this study. In sitting position, dorsiflexion angles of the first MTP joint were measured with maximum ankle dorsiflexion on each side. ICC (3,1) and ICC (3,k) models were used, respectively, to assess the intra-reliability and inter-reliability of the flexor hallucis longus stretch test. The paired-t test was used to compare the dorsiflexion angle of the first MTP joint on the side with the smaller HV angle with that of the side with the larger HV angle. Results: The results of the study showed that both intra- and inter-reliability were more than 0.95 of the coefficient. Dorsiflexion angle of the first MTP joint was higher on the side with the smaller HV angle. Conclusion: Use of the flexor hallucis longus stretch test is acceptable in clinical settings because both intra- and inter-reliability were high in subjects with asymmetric HV angles. In addition, shortness of the flexor hallucis longus muscle is associated with HV angle. This study provides useful information for use in management of HV deformity.

• Journal of Korean Foot and Ankle Society
• /
• v.8 no.2
• /
• pp.138-141
• /
• 2004

Purpose: The purpose of this study was to document the results of fixation with ethibond suture in akin osteotomy and its advantages. Materials and Methods: From May 2001 to January 2004, Akin osteotomy was performed in 218 patients. We reviewed 110 patients (114 feet) who were possible radiographic evaluation more than 6 months after operation. 110 feet had hallux valgus and 4 feet had hallux valgus interphalangeus. 105 patients were female and 5 were male. The average age was 43.8 years old (18 to 68 years old). The average follow up was 9 months (6 to 23 months). After performing the Akin osteotomy at 7 mm from the proximal articular surface of the proximal phalanx, one hole is made on either side of the osteotomy site with a K-wire. The passer was passed through the both holes and the ethibond was passed. And then, the ethibond was tied tightly. 2 sutures in 66 feet and 1 suture in 48 feet were made. Radiographic bone union at 6 months follow up was regarded as success and loss of the reduction, nonunion was regarded as failed. Results: In the radiographic evaluation, bony union were made at 6 months follow up in all feet. There was no difference between 2 sutures and 1 suture, and the knots were removed in 3 feet because of skin irritation. Conclusion: The fixation of the osteotomy site using suture material was an effective method in Akin osteotomy. The advantage of this procedure was unnecessity of the material removal.

• Journal of Korean Foot and Ankle Society
• /
• v.9 no.1
• /
• pp.13-19
• /
• 2005

Purpose: To determine the radiographic changes in forefoot geometry with weight-bearing. Materials and Methods: The forefoot radiographs of 100 normal Korean adults, 50 male and 50 female volunteers, were evaluated both in nonweight-bearing and weight-bearing. The mean age was 27 years with range of 21-39 years. Those with normal feet were selected from volunteers having no history of foot problems or other musculoskeletal diseases. Results: The changes of measured angle between phalanges and metatarsals with weight-bearing were as follows; Hallux valgus angle was noted to increase in 20% of the feet, decrease in 59%, and remained unchange in 21%. Intermetatarsal angle $1{\sim}2$ was noted to increase in 76% of the feet, decrease in 3%, and remained unchange in 21%. Intermetatarsal angle $1{\sim}5$ was noted to increase in 95% and remained unchange in 5%. Shift in medial sesamoid on weight-bearing was also not consistent. Lateral shift was noted in 27%, no shift in 66%, medial shift in 7%. Conclusion: The generalized concept that the angles between bones and shift of medial sesamoid in the forefoot will change consistently with weightbearing was not found.