• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.13-17
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• 2007

Purpose: In order to achieve successful outcome for the hallux valgus surgery, it is mandatory to consider the possible associated hallux valgus interphalangeus, and therefore the hallux interphalangeal angle (HIA) other than hallux valgus angle (HVA) and intermetatarsal angle (IMA) has been well appreciated. The purpose of this study is to evaluate the incidence of hallux interphalangeal angle in the normal and hallux valgus feet and also the statistical correlations of HIA with HVA and IMA in the 2 groups. Materials and Methods: The study is base on the standing foot AP radiographs of the 100 normal feet (HVA<$12^{\circ}$ and $IMA<9^{\circ}$) and 100 hallux valgus feet (HVA>$25^{\circ}$ and IMA>$12^{\circ}$). We measured the hallux valgus angle, intermetatarsal angle and hallux interphalangeal angle, where we defined the hallux valgus interphalangeus when the HIA was more than $10^{\circ}$. We evaluated the incidence of the hallux valgus interphalangeus in the normal and hallux valgus groups and the correlations of the HIA with HVA and IMA. Results: In normal feet group, hallux valgus interphalangeus comprised 82%, while there were only 20% of HVI in hallux valgus group. Among 200 total feet, there was negative correlations between the HVA and HIA as well as IMA and HIA statistically (p<0.01). Conclusion: There was lower incidence of hallux valgus interphalangeus in the hallux valgus group compared to the normal feet group.

• Physical Therapy Korea
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• v.8 no.2
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• pp.17-27
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• 2001

The purpose of this study was to investigate the effect of donning of a hard insole in patients with hallux valgus. Fourteen subjects were selected from patient with foot pain at Lee Chang-Heon Foot Clinic from August 4, 2000 to September 15, 2000. The hallux valgus angle and the first-second intermetatarsal angle were radiographically measured before and after donning the hard insole. Based on these two kinds of angles, a mild hallux valgus deformity group was characterized by the hallux valgus angle of less than 20 degrees, and a moderate hallux valgus deformity group was characterized by the hallux valgus angle of 20 to 40 degrees. After three weeks with the hard insole donned, the foot angles of the patients with hallux valgus were measured again. The data were analyzed by Wilcoxon signed ranks test, and the following results were obtained: 1) After the trial, both mild hallux valgus deformity group and moderate hallux valgus deformity group demonstrated that the hallux valgus angles were significantly decreased. 2) After the trial, mild hallux valgus deformity group demonstrated that the first-second intermetatarsal angle was significantly decreased. 3) After the trial, moderate hallux valgus deformity group demonstrated that the first-second intermetatarsal angle was not significantly decreased. The above findings revealed that according to donning hard insole, the hallux valgus angles of mild and moderate hallux valgus deformity groups and the first-second intermetatarsal angle of mild hallux valgus deformity group were significantly decreased. The results of this study have some limitation for generalization due to the limited number of subjects. Further studies are needed to evaluate the effect of hard insole on hallux valgus with more precise laboratory equipments and measurements in patients with hallux valgus.

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.2
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• pp.63-72
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• 2015

Purpose: The purpose of this study was to investigate the foot pressure of subjects with hallux valgus following conservative management. Methods: The subjects (20 females) were divided into 2 groups; Hallux valgus group (10) and Control group (10) who could evaluate questionnaire & weight bearing X-ray. All the participants were evaluated distribution of foot pressure by Zebris FDM-S system with conservative management (taping therapy and hallux valgus device) during single-limb stance. Results: The Hallux valgus group (HVG) was significantly different than Control group (CG) in hallux valgus angle(p<0.05). The Hallux valgus group with Foot Device (HVG-FD), Hallux valgus group with Taping (HVG-Tp) and Hallux valgus group with Foot device and Taping (HVG-FD&Tp) was not significantly different than CG in hallux valgus angle (p<0.05). The HVG was not significantly different than CG in forefoot (p1, p2, p3), significantly different than CG in rearfoot (p7) about foot pressure during single-limb stance (p<0.05). The HVG-FO and HVG-FO and TP was significantly different than HVG in forefoot (p1, p2, p3), on significantly different than HVG in rearfoot (p7) about foot pressure during single-limb stance (p<0.05). There was significantly correlation HVG-FO and HVG-FO & TP in forefoot (p1, p2, p3) was negative correlation (p<0.05) and in rearfoot (p7) was positive correlation (p<0.05). Conclusion: This study showed that hallux valgus were effected hallux valgus angle and foot pressure by various treatment methods during single-limb stance. Further study is needed to measure various age and work with hallux valgus for clinical application.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.14-19
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• 2008

Purpose: We tried to understand the effects of the derotational closing wedge Akin osteotomy during the operation for the hallux valgus with pronation of great toe. Materials and Methods: Eighty five patients who had undergone Akin osteotomy among the eighty seven patients who had been treated with Scarf osteotomy with hallux valgus were included in this study. Derotational supination was added on the medial closing wedge Akin osteotomy at the base of proximal phalanx and it was secured with K-wire, headless screw or staple. We measured and analyzed pre- and post-operative hallux primus valgus angle and hallux pronational rotatory angle. Results: The hallux primus valgus angle improved an average of $14{\pm}2.98$ degrees to $-1{\pm}1.68$ degrees with the hallux pronational rotatory angle respectively from $24.8{\pm}7.64$ degrees to $4.7{\pm}4.22$ degrees. Conclusions: After the metatarsal osteotomy for the treatment of the hallux valgus with the pronation of great toe, derotational closing wedge Akin osteotomy can give us a belief that it can correct the hallux primus valgus angle and hallux pronational rotatory angle also and it can be a helpful method for minimizing the recurrence rate of the hallux valgus deformity.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.101-108
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• 2003

Purpose: To evaluate and analyze the incidence, clinical features, cause and surgical outcomes of iatrogenic hallux varus deformity after hallux valgus surgery. Materials and Methods: Twenty-six Hallux varus deformities after hallux valgus surgery were evaluated. Clinical tolerability, patient's satisfaction and the main causative factor for varus deformity were evaluated. Radiologically, we measured the 1st intermetatarsal angle and hallux valgus angle on pre- & postoperatively. Results: 10 cases of 26 varus deformities were clinically intolerable. The patients complaint of mainly cosmetic and shoe fitting problems rather than pain and the main cause of deformities were over-correction of 1 st intermetatarsal angle. Radiologically, the average 1st intermetatarsal angle was 2.4 degrees and the hallux valgus angle was -9.2 degrees. After varus correction surgery, the average follow up were 17 months and the average 1st intermetatarsal angle was 2.3 degrees and the hallux valgus angle was 2.7 degrees. The average score of AOFAS Hallux Metatarsophalangeal -Interphalangeal Scale was 91 points. Conclusion: The hallux varus deformity after hallux valgus surgery came from mainly overcorrection of 1 st intermetatarsal angle. The management composed of just observation, tendon transfer and fusion, and each method could get satifactory results with appropriate indication.

• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.102-106
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• 2020

A postoperative hallux varus deformity is a dreaded complication of hallux valgus surgery. Several surgical options have been introduced to overcome this problem. This paper reports an uncommon case of a 68-year-old female patient who presented with a postoperative hallux varus deformity combined with a rupture of the flexor hallucis longus (FHL) tendon. She was treated successfully by a minimally invasive correctional osteotomy with open tenorrhaphy. With experience in treating this complicated case, it was noted that FHL could be transected during the trans-articular adductor tenotomy. Hence, extra caution is needed when the degree of hallux valgus deformity is excessive. To the best of the author's knowledge, correctional valgization osteotomy for a postoperative hallux varus deformity in a minimally invasive manner has not been reported. This case report is expected to benefit surgeons and their patients with severe hallux valgus deformity.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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• pp.69-77
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• 2022

PURPOSE: In this study, we sought to investigate the effect of conservative ankle strengthening exercise programs using a Bosu® ball or taping, on the hallux valgus angle and the pain of hallux valgus patients in their 20s. METHODS: The hallux valgus angle, balance, and pain after measuring the hallux valgus were measured to select suitable subjects. In the ankle strengthening exercise group (ASG) an ankle strengthening exercise program using a Bosu® ball was performed for two sessions weekly for four weeks and the taping group (TG) was given Kinesiotaping® for two sessions weekly, two days per session, for four weeks. Before and after the experiment, a footprint was used to examine the changes in the hallux valgus angle and the visual analog scale (VAS) was used to measure pain. RESULTS: An evaluation of the post-experiment changes in the hallux valgus angle and pain showed statistically significant improvement in both groups. There was no statistically significant improvement between groups. CONCLUSION: These results show that both ankle strengthening exercises and Kinesiotaping® have a positive effect on the hallux valgus angle and pain.

• Journal of Korean Foot and Ankle Society
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• v.4 no.1
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• pp.23-29
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• 2000

Acquired Hallux varus is defined radiographically by a negative metatarsophalangeal angle and clinically by adduction of the hallux on the first metatarsal and most commonly occurs after hallux valgus surgery. It's the prevalence has ranged from 2% to 17%. We report a case of hallux varus resulted from weakening of support of lateral soft tissue and resection of an excessive amount of the metatarsal head during a bunionectomy after initial correction of hallux valgus. We corrected the hallux varus deformity using transfer of extensor hallucis brevis tendon with reconstruction os lateral capsule.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.9-13
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• 2008

Purpose: Medial capsulorrhaphy is additional hallux reduction method following various hallux reduction procedures and we are going to report author's opinion about several methods of medial capsulorrhaphy. Materials and Methods: We performed three kinds of medial capsulotomy and imbricatory capsulorrhaphy in hallux valgus surgery. Through 8 cadavar study, we compared the easiness of sesamoid reduction and hallux valgus angle reduction. Also, we measured thickness of capsule in various portions. Results: Longitudinal capsule incision and imbrication was useful in sesamoid reduction and vertical procedures was useful in hallux valgus angle reduction. The capsule thickness was measured thickest in dorsal and distal portioin. Conclusion: The methods of medial capsulorrhaphy should be planned preoperatively considering individual hallux deformities. These selected medial capsulorrhaphy can help the reduction of hallux valgus deformity correction and its maintenance.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.16-20
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• 2010

Purpose: This study analyzed the clinical and radiographic outcome of the severe hallux valgus corrected with proximal reverse chevron metatarsal osteotomy and Akin osteotomy. Materials and Methods: The study was based on 18 feet (15 patients) of severe hallux valgus (hallux valgus angle ${\geq}40^{\circ}$ or intermetatarsal angle ${\geq}18^{\circ}$) treated with proximal reverse chevron metatarsal osteotomy and followed for more than 1 year. Akin osteotmy was added in 72% of the patients. Clinically preoperative and postoperative AOFAS Hallux Metatarsophalangeal-interphalangeal score, VAS pain score and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. Results: AOFAS Hallux Metatarsophalangeal-interphalangeal score improved from 54.5 (25-78) to 87.7 (70-100) and VAS pain score decreased from 6.0 (3-8) to postoperative 1.2 (0-5). Ninety-six percents of the patients were satisfied with results. Radiologically hallux valgus angle was decreased from $43.3^{\circ}(31-58^{\circ})$ preoperatively to $6.8^{\circ}(-8-27^{\circ})$ postoperatively. The intermetatarsal angle was decreased from $18.4^{\circ}(11-24)^{\circ}$ preoperatively to $5.3^{\circ}(1-12^{\circ})$postoperatively. The sesamoid subluxation was improved from $2.8{\pm}0.4$ preoperatively to $0.4{\pm}0.6$ postoperatively. Conclusion: Proximal reverse chevron metatarsal osteotomy and lateral soft tissue release with additional Akin osteotomy is good treatment option for severe hallux valgus.