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Increased Incidence and Severity of Postoperative Radiographic Hallux Valgus Interphalangeus With Surgical Correction of Hallux Valgus.

Abstract：

BACKGROUND:A previous study has shown an increased radiographic prevalence and severity of hallux valgus interphalangeus (HVIP) after surgical correction of hallux valgus (HV) due to correction of pronation deformity. The purpose of this study was to evaluate the change in pre- and postoperative HVIP deformity with correction of HV with multiple radiographic parameters. METHODS:A retrospective chart review identified all bunion surgeries performed at a single center from July 1, 2009, to September 30, 2012. Exclusion criteria included prior bony surgery to the first ray, inadequate films, nonadult bunion, Akin osteotomy, or surgical treatment other than bunion correction. Pre- and postoperative films were reviewed for 2 HV angular measurements and 5 HVIP measurements, which were compared. The angles measured were hallux valgus angle (HVA), first intermetatarsal angle (IMA), hallux interphalangeus angle (HIA), distal metatarsal articular angle (DMAA), proximal phalangeal articular angle (PPAA), proximal to distal phalangeal articular angle (PDPAA), and total distal deformity (TDD). Prevalence of HVIP was analyzed in pre- and postoperative radiographs. A 1-sided Student t test was used to compare continuous data, and a chi-square test was used to compare categorical data. Ninety-two feet in 82 patients were eligible. RESULTS:The average preoperative HV improved with surgery. Preoperative HVA improved from 27 to 11 degrees (P < .001). Preoperative IMA improved from 13.6 to 6.1 degrees (P < .001). HVIP worsened after surgery. Preoperative HIA increased from 7.2 to 13.2 degrees (P < .001). DMAA worsened from 7.3 to 9.2 degrees (P = .001). PPAA worsened from 3.2 to 6.2 degrees. PDPAA worsened from 6.7 to 8.2 degrees (P < .001). The TDD increased from 14.6 to 17.9 degrees (P < .001). The prevalence of HVIP pre- and postoperatively as defined by HIA increased from 26% to 79% (P < .001) and by PPAA from 12% to 46% (P < .001). CONCLUSION:Initial assessment of preoperative radiographs underestimated HVIP. Postoperative correction of the deformity revealed HVIP that was not obvious preoperatively. LEVEL OF EVIDENCE:Level III, retrospective comparative series.

journal_name

Foot Ankle Int

journal_title

Foot & ankle international

authors

Dixon AE,Lee LC,Charlton TP,Thordarson DB

doi

10.1177/1071100715579905

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

961-8

issue

eissn

1071-1007

issn

1944-7876

pii

1071100715579905

journal_volume

pub_type

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Increased Incidence and Severity of Postoperative Radiographic Hallux Valgus Interphalangeus With Surgical Correction of Hallux Valgus.