• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.5-11
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• 1997

Multiple surgical procedures for the correction of hallux valgus have been described. The surgical algorithm is based on the degree of deformity, patient's age, and the presence or absence of arthritis. It is known that the role of an isolated distal soft-tissue procedure is limited and the procedure must be used in conjunction with the proximal metatarsal osteotomy to correct most hallux valgus. We reviewed retrospectively the clinical & radiological results of distal soft-tissue procedure with or without proximal metatarsal osteotomy, performed in 18 patients (29 cases ) who had mild to moderate degrees af hallux valgus deformity. The results were as follows : In 20 cases with isolated soft-tissue procedures, the preoperative hallux valgus angle (HV) averaged 30.6 degrees and the postoperative HV averaged 7.3 degrees. The preoperative intermetatarsal angle (IM) averaged 12.5 degrees and postoperative IM averaged 10.4 degrees. 2. In 9 cases with the proximal metatarsal osteotomy added, the preoperative HV averaged 32.5 degrees, and the postoperative HV averaged 8.0 degrees. The preoperative IM averaged 12.5 degrees, and postoperative IM averaged 10.1 degrees. 3. There was no significant difference of loss of correction, presence of complication, patients own satisfaction, between two groups. In conclusion, as for the patients with mild to moderate degrees of hallux valgus deformities, the clinical and radiological results following distal soft tissue procedure and proximal metatarsal osteotamy are not proved to be superior to those following isolated soft-tissue procedures.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.160-165
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• 2007

Purpose: Good results using minimal invasive hallux valgus surgery has been reported recently. We evaluate the usefulness of linear distal metatarsal osteotomy with minimal skin incision in mild and moderate hallux valgus deformity. Materials and Methods: Twenty-eight patients (thirty-one cases) who had mild to moderate hallux valgus deformity and underwent linear distal metatarsal osteotomy using minimal skin incision were evaluated between February 2005 and February 2006. Hallux-metatarsophalangeal-interphalangeal scale of AOFAS (American Orthopaedic Foot and Ankle Society) score was used as clinical evaluation. Preoperative, postoperative, after pin removal, and final follow up plain radiographs were used as radiologic evaluation. Results: Twenty-six cases (83%) among thirty-one cases showed more than average satisfaction, Average AOFAS score were improved from 63.2 points (range 45-74 points) to 86.4 points (range 67-93 points). Preoperative radiologic index of IMA $14.0^{\circ}$ (range $10-18^{\circ}$), HVA $30.2^{\circ}$ (range $19-39^{\circ}$), DMAA $13.8^{\circ}$ (range $5-23^{\circ}$) were improved postoperatively as IMA $8.3^{\circ}$ (range $5-10^{\circ}$), HVA $10.5^{\circ}$ (range $2-20^{\circ}$), DMAA $7.2^{\circ}$ (range $0-14^{\circ}$) correctively. Mean operative time was 15.5 minutes (range 11-18 minutes) and mean operative time was 5.6 days (range 2-8 days). Conclusion: Despite small skin incision and short operative time and admission period, linear distal metatarsal osteotomy with minimal skin incision showed similar results with conventional distal metatarsal osteotomy. Thus, it was thought to be useful operation in mild and moderate hallux valgus deformity.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.20-25
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• 2008

Purpose: The purpose of this study is comparison of radiological and clinical outcomes between proximal metatarsal osteotomy and distal chevron osteotomy for the correction of hallux valgus. Materials and Methods: In this retrospective study, we included subjects who underwent the correction of hallux valgus in our institution between March 2001 and August 2006, with a minimum follow-up of 12 months. The group of proximal metatarsal osteotomy was 23 patients (34 feet); the group of distal chevron osteotomy was 20 patients (26 feet). The group of proximal metatarsal osteotomy was composed of 26 severe cases (76.5%) and 8 moderate cases (23.5%); the group of distal chevron osteotomy was composed of 13 severe cases (50.0%) and 13 moderate cases (50.0%). Results: Compared to preoperative values, the hallux valgus angle, the first-second intermetatarsal angle and the distance of first-fifth metatarsal head were significantly decreased in two groups (p<0.05). In each parameter, the hallux valgus angle was decreased 66.3% (proximal metatarsal osteotomy) versus 49.6% (distal chevron osteotomy), which were significant (p=0.037). The first-second intermetatarsal angle and the distance of first-fifth metatarsal head were not significant. Mayo clinic forefoot scoring system (FFSS) score was significantly improved in two groups (p<0.05). The ratio of improvement was not significant (p=0.762). In severe group, hallux valgus angle and the first-second intermetatarsal angle was significantly decreased in proximal metatarsal osteotomy group compared to distal chevron osteotomy group (p<0.05), but the difference of the distance of first-fifth metatarsal head and FFSS score was not significant in both groups. In moderate group, the difference of all parameters was not significant in both groups. Conclusion: Although both proximal metatarsal osteotomy and distal chevron osteotomy showed satisfactory result in FFSS, proximal metatarsal osteotomy was more proper operative technique than distal chevron osteotomy in severe group, because of superiority of correction in radiological parameters.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.223-229
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• 2006

Purpose: The purpose of this study was to analyze the results of the treatment of hallux valgus with metatarsal double osteotomy and longitudinal pin fixation. Materials and Methods: We reviewed 19 patients (21 feet) who had been treated by metatarsal double osteotomy and longitudinal pin fixation for the moderate or severe hallux valgus with increased distal metatarsal articular angle (DMAA), between 1999 and 2004. They were followed prospectively for a minimum of 20 months. Functional outcomes were measured via Hallux metatarsophalangeal-Interphalangeal (HMI) scale and Mayo clinic forefoot scoring system (FFSS). Radiographically, we assessed pre, postoperative and at the last follow-up, the hallux valgus angle (HVA), 1st and 2nd intermetararsal angle (IMA), DMAA. Results: The average preoperative HVA, IMA, DMAA measured $36.76^{\circ}$, $13.62^{\circ}$, $26.00^{\circ}$, respectively. At the last follow-up, HVA, IMA, DMAA measured $9.57^{\circ}$, $7.14^{\circ}$, $9.33^{\circ}$. The correction of HVA, IMA, DMAA were $27.19^{\circ}$, $6.48^{\circ}$, $6.67^{\circ}$. At the last follow-up, there were no recurrences and complications, except two patients complained of unsatisfactory stiffness in the 1st metatarsophalangeal joint and subjectively rated their results as fair. The others rated that as excellent or good. At the last follow-up, statistically, the mean HMI scale and FFSS improved significantly from pre-operative score. Conclusions: In the treatment of moderate or severe hallux valgus with increased DMAA by metatarsal double osteotomy and longitudinal pin fixation, we had good functional and radiological results without recurrences and significant complications. But the stiffness in the 1st metatarsophalangeal joint warrants further study.

• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.47-52
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• 2012

Purpose: The purpose of this study is to evaluate the effect of axial shortening metatarsal osteotomy on the treatment of advanced rheumatoid arthritis patients with severe hallux valgus and claw toe deformity of lesser toes which is used for preserving the metatarsophalangeal joint. Materials and Methods: From January 2005 to June 2009, 18 cases of axial shortening metatarsal osteotomy in advanced rheumatoid arthritis were reviewed ; all of them followed up for more than 2 years after surgical procedures and the mean follow up period was 3.4 years. We performed axial shortening Scarf osteotomy and Akin osteotomy for hallux valgus and Weil osteotomy with soft tissue release for claw toe of lesser toes, respectively. We measured preoperative and postoperative hallux valgus angle, each metatarsal shortening length and the range of motion of the metatarsophalangeal joints through radiographic and clinical examination and compared them each other. Clinical results were evaluated by American Orthopedic Foot and Ankle Society (AOFAS) score and subjective satisfaction of the patients. Results: The hallux valgus angle was reduced from the preoperative mean value of 44.8 degree to 9.0 degree postoperatively and the range of motion of the metatarsophalangeal joint of great toe and lesser toes was increased from the mean of 21.7 degree and 11.0 degree preoperatively to 38.0 degree and 32.5 degree, respectively at postoperation. Also, the mean AOFAS score was improved from 26.5 points to 67.4 points. Conclusion: Axial shortening osteotomy is a useful method to correct the deformity and preserve the metatarsophalangeal joint for severe hallux valgus and claw toe deformity in advanced rheumatoid arthritis.

• Journal of Korean Foot and Ankle Society
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• v.24 no.4
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• pp.129-134
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• 2020

Purpose: This study compared the results of proximal and distal chevron osteotomy in patients with severe hallux valgus. Several recent studies have shown that the indications for distal metatarsal osteotomy with a distal soft-tissue procedure could be extended to include severe hallux valgus. Materials and Methods: This study analyzed 127 severe hallux valgus surgeries. Of these, 76 patients (76 feet) were excluded for lack of adequate follow-up and additional procedures (Akin procedure), leaving 51 patients (51 feet) in the study. The mean age of the patients was 58 years (21~83 years), and the mean follow-up duration was 18 months (12~32 months). The patients were divided into two groups. Group 1 underwent distal chevron osteotomy, and group 2 underwent proximal chevron osteotomy performed sequentially by a single surgeon. The patients were interviewed for the American Orthopaedic Foot and Ankle Society (AOFAS) score before and one year after surgery. The anteroposterior weight-bearing radiography of the foot was taken before and one year after surgery. Results: There were no significant differences in pain and function after one year in either group. Both groups experienced significant pain reduction and an increase in the AOFAS score. Significant improvement of the hallux valgus and intermetatarsal angle corrections was observed in both groups, and the sesamoid position was similar in each group. More improvement in radiographic correction of intermetatarsal angle was noted in group 2. Both procedures gave similar good clinical and radiological outcomes. Conclusion: This study suggests that a distal chevron osteotomy with a distal soft-tissue procedure is as effective and reliable a means of correcting severe hallux valgus as a proximal chevron osteotomy with a distal soft-tissue procedure.

• The Journal of Korean Obstetrics and Gynecology
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• v.28 no.2
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• pp.183-192
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• 2015

Objectives : This study aims to report the effect of Korean medicine treatments on a sequela of operation of hallux valgus. Methods : The patient was treated with Dangkisoosan-gami, Acupuncture treatment including Herbal-Acupuncture and physical therapy. We evaluated treatment effects by circumference of foot and ankle, Edema index score by Body Composition Analyzer, Ankle-Brachial Index (ABI) and Visual Analogue Scale (VAS). Results : After 25 days of treatment, the symptoms such as lower extremity edema, foot pain and ankle pain were improved. Conclusions : In this case, Korean medicine treatments for a sequela of operation of hallux valgus was effective. But further studies are required to confirm the effect of these methods.

• Journal of Biomedical Engineering Research
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• v.18 no.4
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• pp.439-446
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• 1997

We undertook this study to determine the plantar pressure distribution characteristics of hallux valgus, major increasing foot disease. Twenty three valgus Patients were evaluated with clinical examinations, radiologic studies and dynamic plantar pressure distribution measurements. The present study also suggested a masking method for detailed analyses on plantar pressure distribution measurements. With higher grade of hallux valgus, pressure, contact area, and impulse on metartasus are significantly increased Pressure concentration is very important in foot diseases and an approximate plantar pressure distribution should be considered on any shoe design.

• Journal of Korean Foot and Ankle Society
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• v.2 no.1
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• pp.1-5
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• 1998

In a retrospective study, we compared the results of 24 cases of Chevron osteotomies with those of 17cases of Wilsons osteotomies in the treatment of hallux valgus. We used FFSS(Fore Foot Scoring System) and radiographic findings. There were no differences between the two operations in terms of pain relief and appearance. All patients in the Chevron and Wilsons osteotomy group had good functional results and were more satisfied with the appearance of the foot. We conclude Wilsons osteotomy is useful method for correction of hallux valgus.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1614-1618
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• 2018

The purpose of this study was to evaluate the effect of joint mobilization and manual stretching exercises in patients with hallux valgus. Twenty-three participants were divided into two groups; joint mobilization (n=11) and manual stretching exercises (n=12). The subjects participated in the experiment for 15minutes, three times a week, four weeks. The joint mobilization (Grade III, Maitland) was performed to experimental group for a minute and then rested for 10 seconds for each set. The manual stretching was performed to control group with three exercise session (preparatory and finishing exercises, agonist contraction exercises, agonist contraction and hold-relax exercises). In the results of the study, intragroup comparison of the deformity angles (DA) was shown to decrease from $15.18^{\circ}$ to $13.09^{\circ}$ in the joint mobilization group (p<.05) and from $19.00^{\circ}$ to $16.83^{\circ}$ in the stretching exercises group (p<.05). However, left static foot pressure (LSFP), right static foot pressure (RSFP), left dynamic foot pressure (LDFP) and right dynamic foot pressure (RDFP) did not significantly increase or decrease after the experiment. Intergroup differences also were not statistically significant in all variables (p>.05). The current study suggests that JM and MSE are effective in decreasing the DA in patients with hallux valgus.