• Title/Summary/Keyword: Severe hallux valgus

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The Efficacy of Postoperative Ultrasound-Guided Sciatic Nerve Block to Relieve Pain after Hallux Valgus Surgery (무지 외반증 수술 후 통증조절을 위한 초음파 유도하 좌골신경 차단술의 유용성)

  • Lee, Jin Chul;Yune, Young-Phil
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.3
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    • pp.135-139
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    • 2016
  • Purpose: Modified Mau and Akin osteotomy for hallux valgus is followed by moderate to severe postoperative pain. Ultrasound-guided sciatic nerve block can be an effective option for pain control. We attempted to evaluate the efficacy of the ultrasound-guided sciatic nerve block in controlling postoperative pain. Materials and Methods: The charts of 59 consecutive patients were retrospectively reviewed between December 2014 and August 2015. Twenty-eight patients (the patient group) has received the ultrasound-guided sciatic nerve block after surgery, and 31 patients (the control group) has not received such procedure. The primary outcome was the satisfaction scale for postoperative pain control and postoperative visual analogue scale (VAS) score. Results: The VAS score at postoperative day one was significantly lower in the patient group than in the control group. The satisfaction scale for pain control for postoperative 1 day was significantly different between the two groups. In patient group, most patients have rated positively ('strongly agree' 42.9%, 'agree' 42.9%); however, in the control group, the rating scales were distributed relatively negatively ('strongly agree' 9.7%, 'agree' 22.6%, 'neutral' 29.0%, 'disagree' 25.8%, 'strongly disagree' 12.9%). The number of postoperative rescue analgesics injection was significantly lower in the patient group than in the control group. Conclusion: Postoperative ultrasound-guided sciatic nerve block was effective for pain relief after hallux valgus surgery.

Differences of 1-2 Intermetatarsal Angle between Intra-operative nonweight-bearing and Postoperative weight-bearing in Proximal Metatarsal Osteotomy for Hallux Valgus (무지 외반증의 근위 중족골 절골술에 있어서 수술 중 비체중부하와 수술 후 제중부하 방사선 소견에서의 제 1-2 종족골간 각의 차이)

  • Sung, Il-Hoon;Kim, Joo-Hak;Whang, Khun-Sung
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.7-12
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    • 2003
  • Purpose: To study the relationship of the 1st to 2nd intermetatarsal angle(1-2 IMA) between the intra-operative and weight bearing postoperative anterior-posterior(AP) radiography, and evaluate the intra-operative predictability for the postoperative 1-2 IMA after proximal metatarsal osteotomy(PMO) in the hallux valgus deformity. Materials and Methods: 20 cases of moderate to severe hallux valgus patients were included in this study. After the oblique PMO(Ludloff procedure) was performed and the osteotomy site was fixed temporarily, the AP view was taken intra-operatively. About 10 weeks after surgery, postoperative weight bearing AP view was taken. The pre -. intra -, and postoperative 1-2 IMAs were compared and ana lysed statistically. Results: The 1-2 IMAs of the weight bearing preoperative, non-weight bearing intra-operative and weight bearing postoperative AP view were $15.9^{\circ}{\pm}1.8^{\circ},\;4.7^{\circ}{\pm}2.1^{\circ}$, and $6.8^{\circ}{\pm}2.5^{\circ}$ (Mean${\pm}$SD) respectively. The postoperative 1-2 IMA was greater than intra-operative measurement by $2.1^{\circ}{\pm}1.8^{\circ}$ (range; $-1^{\circ}$ to $6^{\circ}$) which was stastistically significant(p<0.05). To get less than $9^{\circ}$ postoperatively as an average normal, intra-operative 1-2 IMA should be within $3.8^{\circ}$ to $5.2^{\circ}$ (95% confidence interval), and intra-operative 1-2 IMA should be within $3.4^{\circ}{\pm}$to $5.4^{\circ}$(95% confidence interval) to get more than $6^{\circ}$ difference between preoperative and postoperative 1-2 IMA, which is regarded as more than average correction by the distal metatarsal osteotomy. Conclusion: In hallux valgus surgery, it should be considered that intra-operative 1-2 IMA was less than the postoperative. To achieve postoperative 1-2 IMA less than $9^{\circ}$ and more than correction angle of $6^{\circ}$, it is suggested that the intra-operative 1-2 IMA should be measured less than about $5^{\circ}$.

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Effects of hallux valgus angle on one-legged stance and gait parameters in young adults: a preliminary study

  • Ji, Minkyung;Park, Hyodong;Lee, Heeyeon;Yoo, Minjoo;Ko, Eunsan;Woo, Youngkeun
    • Physical Therapy Rehabilitation Science
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    • v.9 no.1
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    • pp.10-17
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    • 2020
  • Objective: Hallux valgus (HV) is a common musculoskeletal deformity that is accompanied with pain and continues to decrease one's quality of life and ability to perform daily life activities by affecting gait and static stability. Therefore, this study aimed to investigate the effect of the angle of HV (HVA) and to compare the one-legged stance and gait parameters in young adults with less HV and severe HV. Design: Cross-sectional study. Methods: Forty young adults were divided into two groups, where HVA ≥15° (n=20) was defined as HV, and HVA <15° (n=20) was defined as normal. For balance ability, the center of pressure (COP) path, velocity, length of axis of the COP path, deviation of the x-axis and y-axis, and percentage of foot pressure were measured, and gait, the foot rotation angle, step length, percentage of each phase of the gait cycle, time change from the heel to forefoot, and maximum pressure of the forefoot and midfoot were measured. Results: Significant differences were found in sway length and time change from heel to forefoot during walking between the normal and HV groups (p<0.05). Most parameters were not associated with the HVA, but parameters such as length of axis and time to change from heel to forefoot were significantly associated with the HVA (p<0.05). Conclusions: These results suggest that most one-legged stance and gait parameters were not significantly affected by the HVA in young adults; therefore, future studies are needed in order to address other dynamic parameters and other methods of gait analysis for detecting clinically meaningful conditions.

Response to: Comment on"Comparison of Operative Results of Distal Chevron Osteotomy with and without Akin Osteotomy for Moderate to Severe Hallux Valgus" (저자 답변: "중등도 및 중증의 무지외반증에서 Akin 절골술 동반 유무에 따른 원위부 갈매기형 절골술의 수술 결과 비교"에 대한 견해)

Mid-Term Results of Modified Hoffman Procedure for Rheumatoid Forefoot Deformity (류마티스 전족부 변형에 대한 변형 Hoffman 술식의 중기 결과)

  • Kim, Yoon-Chung;Choi, Hyun Chul;Lee, Hyo Jin;Ahn, Jae Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.484-490
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    • 2021
  • Purpose: A rheumatoid forefoot deformity includes severe hallux valgus and claw toe of the four lateral toes. The authors intended to analyze the mid-term results of the modified Hoffman procedure for a rheumatoid forefoot deformity. Materials and Methods: Twenty-two feet of eighteen patients were followed up for more than two years after the modified Hoffman procedure. The mean age was 54.7 years, and the mean follow-up period was three years and four months. Clinically visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) MP-IP score were analyzed preoperatively and postoperatively. The postoperative complications, the satisfaction of patients, and the presence of plantar callosity were also analyzed. Radiographically, the hallux valgus angle, the 1st intermetatarsal angle, the 1st interphalangeal angle, the 1st interphalangeal joint arthritic change after the operation, and the dorsiflexion angle and the time to union of the 1st metatarsophalangeal joint were analyzed. Results: Clinically, the VAS and AOFAS score were respectively improved from 7.1 points and 30.3 points preoperatively to 1.5 points and 83.1 points postoperatively (p<0.001). All patients were satisfied with the results. Plantar callosity disappeared in all cases. Radiographically, the mean hallux valgus angle, the 1st intermetatarsal angle, and the 1st interphalangeal angle changed from 52.8°, 13.3°, and 7.5° preoperatively to 16.2°, 8.7°, and 14.6° postoperatively (p<0.001). The mean dorsiflexion angle of the 1st metatarsophalangeal joint was 17.2° postoperatively. The mean time to radiographic union of the 1st metatarsophalangeal joint was 11.1 weeks. There were two cock-up deformities of the lesser toe, one wound problem, and two hallux interphalangeal joint arthritis as a complication. There were no cases of nonunion of the 1st metatarsophalangeal joint. Conclusion: The modified Hoffman procedure appears to be a safe and satisfactory procedure for a rheumatoid forefoot deformity.

Foot Health Condition and Related Characteristics of Nurses (일 대학병원 간호사의 발 건강 상태)

  • Lee, Eun Nam;Kim, Na Geong;Kim, Sun Hee
    • Journal of muscle and joint health
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    • v.27 no.3
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    • pp.289-297
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    • 2020
  • Purpose: This descriptive study aimed to identify the foot health condition and related characteristics of nurses. Methods: A literature-based questionnaire was developed and distributed to 472 nurses in a university hospital in B city, and data were collected from August 1 to August 15, 2020. The Foot Health Status Questionnaire (FHSQ) was used to measure foot health condition. Results: The most common foot diseases among the participants were plantar fasciitis (7.8%) and hallux valgus (7.0%). To relieve foot pain, most nurses used relaxation techniques, stretching, elevating the legs, and foot massage. The level of foot health condition among nurses was lower than that of older persons or the general public with chronic foot disease. The foot health condition of the nurses showed that the lower the age and the greater the number of foot diseases, the more severe the pain and dysfunction. Conclusion: The study shows that there is a need for interventions that will raise nurses' awareness about foot health and induce better foot health management.

Additional axial K-wire Fixation for Proximal Crescentic Metatarsal Osteotomy : A Biomechanical Study (반월형 근위 중족골 절골술에 대한 보강적 축성 K-강선 고정술 : 생체역학적 연구)

  • Jung, Hong-Geun;Kim, You-Jin;Guyton, Gregory
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.151-156
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    • 2003
  • Purpose: Proximal crescentic metatarsal osteotomy(PMO) is one of the most common procedures for correcting moderate to severe degree hallux valgus deformity. Although screw fixation is used for osteotomy site stability, loss of reduction can occur. The purpose of this study is to compare the sagittal plane stability of the conventional crescentic PMO fixed with a single screw with that of the crescentic PMO fixed with 1 screw and 2 supplemental K -wires. Material and Methods: Ten matched pairs of cadaveric foot specimens were used for the proximal crescentic metatarsal osteotomy. For one foot specimen of each pair, crescentic osteotomy was fixed with 4mm long threaded cannulated screw, while the matched pair was prepared by adding two axial 1.6mm K-wires to the conventionally fixed 4mm screw. The extensometer was used to measure the osteotomy gap as the metatarsal head was loaded continuously until failure using a servohydraulic MTS Mini Bionix test frame. The strength of fixation was normalized with the bone mineral density (BMD) of the paired specimen $(N{\times}cm^{2}/gm)$, Result: The average strength of the crescentic PMO with axial K-wire fixation ($458.8cm^{2}/gm$, S.D. 434.3) was significantly higher than the standard crescentic PMO ($367.5cm^{2}/gm$, S.D. 397,9) (p=0.05). Conclusion: Supplemental fixation with two axial K-wires can be added to the crescentic PMO to enhance the initial fixation stability to prevent the loss of reduction or dorsal malunion.

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