• The Journal of Korean Physical Therapy
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• v.13 no.2
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• pp.325-333
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• 2001

The purpose of this study was to find out the effects of hallux valgus on the ankle plantarflexor and dorsiflexor peak torque, on the total work, on the average power, and on the Peak torque of plantarflexor to dorsiflexor ratio values. Isokinetic ankle plantarflexor and dorsiflexor strength was evaluated in 30 women(control: 15, hallux valgus: 15) by Cybex NORM System. Test data was gathered in the right ankle at a speed of 60/sec, 90/sec, 120/sec in the control group and the hallux valgus group. Statistical analysis was performed using SPSS 10.0 for windows software. Mean and standard deviations were measured and calculated for the General characterristic of subjects. A paired t-test was used to examine the differnces in the means for the ankle plantarflexor and dorsiflexor between two groups. Pearson coefficient correlation was used to examine the correlation of the hallux valgus and the peak torque. Analysis of variance indicated that isokinetic values of the control group were greater than the hallux valgus group(p<.05, p<.01).

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.134-139
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• 2008

Purpose: The purpose of this study was to evaluate the radiological and clinical results of modified scarf osteotomy for hallux valgus with lesser metatarsalgia. Materials and Methods: Total 19 patients (24 feet) were reviewed by medical records and radiographs. All patients were female and the mean age at the time of operation was 46.4 years. The mean follow-up time was 14.8 months. We modified original scarf osteotomy by adding the procedure of closing wedge osteotomy at the medial side of distal fragment for achieving of the supination of the first metatarsal head. Additionally, Akin osteotomy of the first proximal phalanx was done in 16 patients (20 feet) and no lesser metatarsal operation was done. First-second intermetatarsal, hallux valgus and distal metatarsal articular angles were analyzed radiologically before and after the operation. And 3-dimensional CT was used to evaluate the supination of the first metatarsal head. Clinical results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) score and persistence of lesser metatarsalgia. Results: First-second intermetatarsal and hallux valgus angles were reduced from the mean pre-operative values of $14.2^{\circ}$ and $32.5^{\circ}$ to $8^{\circ}$ and $12.5^{\circ}$, respectively, 12 months after the operation. And the supination of the first metatarsal head was confirmed by 3-dimensional CT. The mean AOFAS score improved from 41.4 points pre-operatively to 87.2 points at follow-up. Lesser metatarsalgia still remained in 2 patients (2 feet). Conclusion: Modified scarf osteotomy would be an effective surgical procedure, especially, for achieving downward displacement and supination of the first metatarsal head in hallux valgus with lesser metatarsalgia.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.140-144
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• 2008

Purpose: The purpose of this study is to compare the treatment outcomes of distal chevron osteotomy with those of proximal metatarsal closing wedge osteotomy in patients with moderate severity hallux valgus. Materials and Methods: Forty-two patients (51 feet) who were underwent either distal chevron osteotomy (Group I, 22 patients, 27 feet) or proximal metatarsal closing wedge osteotomy (Group II, 20 patients, 24 feet) for the correction of moderate hallux valgus deformity were evaluated retrospectively. We assessed the radiographic results with several parameters including hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). And clinical results with modified AOFAS score at last follow-up. Results: There were no significant differences in IMA, HVA and DMAA between two groups preoperatively. We can achieve the good results with both procedures, but mean HVA and IMA of group II was significantly lower than those of group I. There was some loss of correction in group I at the last follow-up. There was no significant difference in clinical results according to modified AOFAS scoring between two groups at the last follow-up. Conclusion: The proximal metatarsal closing wedge osteotomy for the hallux valgus with moderate severity is better treatment option to achieve better radiographic correction and to prevent loss of correction or recurrence than distal chevron osteotomy.

• The Journal of Korean Physical Therapy
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• v.26 no.2
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• pp.56-61
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• 2014

Purpose: The aim of this study was to investigate relationship between the angle of the first metatarsophalangeal joint (1st MPJ) and the dimensions of the abductor hallucis; dorso-plantar (DP) thickness, medio-lateral (ML) width, and cross-sectional area (CSA), in subjects with and without hallux valgus. Methods: Sixty feet, mean (SD) age of 22.5 (2.1) years old, were included in this study (hallux valgus = 30; control = 30). An X-ray device was used for measurement of the angle of the 1st MPJ, and an ultrasound system was used for determination of mean (SD) DP thickness, ML width, and CSA of the abductor hallucis muscle in each foot from three trials. Results: The results showed the DP thickness, ML width, and CSA of the abductor hallucis did not differ significantly between subjects with and without hallux valgus. In addition, the correlations between the angle of the 1st MPJ and DP thickness, ML width, and CSA of the abductor hallucis showed poor correlation (Pearson r=-0.09, -0.20, and -0.18, respectively). Conclusion: Based on these findings, we speculate that morphological changes to the abductor hallucis muscle cannot be representative of the angle of the 1st MPJ, and also cannot be used in differentiation between subjects with and without hallux valgus.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.47-54
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• 2003

Introduction: Painful plantar callosities under the second and third metatarsal heads are not uncommonly associated with hallux valgus and there have been controversies concerning its treatment modalities. We performed the Weil osteotomy in patients with painful callosities under the second and third metatarsal head associated with hallux valgus, and evaluated the outcome clinically & radiologically. Materials and Methods: From November 2000 through November 2001, out of 51 patients diagnosed with hallux valgus, the Weil osteotomy was performed in 5 women associated with painful callosities under the second and third metatarsal heads. The mean age was 53.4 years (range, 31-66) with a minimum follow-up period of 12 months(range, 12-16). Results: The mean AOFAS lessor metatarso-phalangeal-interphalngeal Scale(LMIS) improved from 61.2 points preoperatively to 88.8 points postopertively. Mean decreases in length of the second and third metatarsal after surgery were 3.2mm and 3mm. Conclusion: We experienced improvement of metatarsalgia in 80% of patients by Weil osteotomy and all patients were symptom-free at last follow-up, suggesting that the Weil osteotomy is an effective procedure in treating painful plantar callosities under the second and third metatarsal heads associated with hallux valgus.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.115-118
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• 2003

Purpose: We are going to present a report from clinical and radiographic results of hallux valgus done only by soft-tissue procedure, when intermetatarsal joint is totally unfit under mild to moderate deformity. Materials and Methods: As a retrospective study, among all the patients who went under the surgery for hallux valgus, and of those who were possible to follow up,(excluding those whose intermetatarsal joint is fit) it was done over 28 cases (18 patients). the soft-tissue procedure was all done by Modified Mc Bride. Results: Hallux valgus angle and intermetatarsal angle each showed correction of $19.4^{\circ}$ and $5.2^{\circ}$, and from the final follow up, they were each decreased by $5.1^{\circ}$ and $1.5^{\circ}$. 21% (6case) were recurred, in one case, the intermetatarsal angle decreasing 120 and the other 5 case all decreased by $13^{\circ}$. Conclusion: when the intermetatarsal joint is unfit and there is no degenerative change, and, if the intermetatarsal angle is not large, moderate hallux valgus can show a good result, just by the distal soft-tissue procedure. a critical indication and a well through out preparation can reduce unneccessary surgeries.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.11-15
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• 2010

Purpose: The purpose of this study was to retrospectively analyze the clinical and radiologic results of the proximal crescentic osteotomy for moderate to severe hallux valgus deformity. Materials and Methods: Between March 2001 and March 2008, 55 patients (71 feet) who had undergone crescentic osteotomy and distal soft tissue procedure for hallux valgus were followed up for more than one year. The average follow-up period was 15.8 months (12~28 months) and the average age at the time of surgery was 49.8 years (20~69 years). We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA), the length of 1st metatarsal bone and the position of medial sesamoid in preoperative and the last follow-up radiographs. The American Othopeaedic Foot and Ankle Society (AOFAS) score and patient satisfaction were measured by modifying Johnson's method which were used for clinical outcome assessments. Results: The HVA and the IMA were 36.2 and 15.8 degrees preoperatively, and 10.8 and 3.9 degrees at the last follow-up, respectively. The amount of shortening of 1st metatarsal bone averaged $2.3{\pm}1.1$ rum postoperatively. The medial sesamoid position improved from a preoperative average of grade 6.6 to the last follow-up average of grade 1.9. The AOFAS score improved from a preoperative average of 45.3 points to an average 90.6 points at the last follow-up. The patient's satisfaction was completely satisfied in 61 cases (85.9%), satisfied with minor reservations in 6 cases (8.5%), satisfied with major reservations in 2 cases (2.8%), and dissatisfied in 2 cases (2.8%). Conclusion: Proximal crescentic osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.

• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.40-44
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• 2013

Purpose: To study inter- and intra-observer reliabilities of computerized measurements of the angular parameters of hallux valgus deformity, using two different kinds of software tools for angle measurement on the digital radiography. Materials and Methods: On 35 digital radiographies of standing foot anteroposterior view of hallux valgus, two observers (A, B) independently measured hallux valgus angle (HVA) and 1-2 intermetatarsal angle ($IMA_{1-2}$) twice, using two methods. In method I, an angle was determined from duplicated lines to longitudinal axes made for bisecting line on the target bones with software tool. In method II, an angle was calculated automatically and directly from bisecting lines (longitudinal axes) made on the target bones. We compared two methods using paired t-test to determine significance of differences. Inter- and intraobserver reliabilities were evaluated using the intraclass correlation coefficients (ICC). Results: There were no significant differences between measurements of method I and II for each observer (p>0.05) and intraobserver reliability were good. (ICC>0.9) Inter-observer reliability for method I and II was good of the HVA (ICCs, 0.912 and 0.905) and moderate of the $IMA_{1-2}$ (ICCs, 0.505 and 0.537). There were interobserver differences in HVA of method I and II. Conclusion: No significant difference was found statistically between measurements of method I and II. Both methods I and II would be acceptable to measure angular parameters of hallux valgus deformity.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.4 no.2
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• pp.96-102
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• 2011

In this study, we performed algorithm development of automatic symptom degree for patient with hallux valgus one of the representative foot disease of morden. And this study proposes an efficient automated technique that is different from the original analog diagnosis for treatment and surgery of hallux valgus using digital image process. And we used X-Ray images of both a normal and a patient with hallux valgus in the procedure. First, we marked the standard angle on the X-Ray image of normal through Overlap & Add technique. Then we created a standard image through thinning filter and roberts filter(edge detection algorithm). Second, we used sobel filter of edge detection algorithm on the X-Ray image of patient. Moreover, we went another overlap & add technique procedure with both normal and patient image that we made. With the output, we projected the display detection image onto the screen. Finally, with the display detection image, we could measure and project the diagnosis angle of hallux valgus. And this confirms that this method is much more practical and applicable for another orthopedics disease than the prior one.

• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.53-57
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• 2012

Purpose: To study computerized measurements of angular parameters on 100% and 150% resized digital radiography of hallux valgus deformity Materials and Methods: 30 digital radiography of standing foot anteroposterior view of hallux valgus patients were included. Two observers(A, B) independently measured hallux valgus angle (HVA), 1-2 intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) in two times on both 100%-size and 150% magnified images respectively, using computerized measurement software tools. The results were interpreted with the statistical software program, Statistical Analysis System, version 9.2. Results: In repeated measurements of each observer, measurements on 150% magnified image showed no differences of all three parameters and with 100%-size image, there were differences of HVA (observer A) and 1-2 IMA (observer B) (p>0.05). When testing interobserver reliability, both observers showed differences in measurement of HVA and DMAA (p<0.05), but no differences in measurement of 1-2 IMA in both images. Within the 95% confidence interval, limits of error of measurements between two observers on HVA, IMA and DMAA were $2.7^{\circ}$ $1.4^{\circ}$ and $5.0^{\circ}$ respectively in 100%-size images, and $2.6^{\circ}$, $1.6^{\circ}$ and $4.7^{\circ}$ respectively in 150% magnified images. Conclusion: In computerized measurements for angular parameters of hallux valgus with digital radiography, 150% magnified images showed intraobserver reliability. Both 100% and 150% magnified images failed to show interobserver reliability. Measurement of 1-2 IMA in both 100% and 150% images showed less interobserver error.