Why do lesser toes deviate laterally in hallux valgus? A radiographic study

Li Yi Roan, Yasuhito Tanaka, Akira Taniguchi, Kiyonori Tomiwa, Tsukasa Kumai, Yuh Min Cheng

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Hallux valgus foot with laterally deviated lesser toes is a complex condition to treat. Ignoring the laterally deviated lesser toes in hallux valgus might result in unsatisfactory foot shape. Without lateral support of the lesser toes, it might increase the risk of recurrence of hallux valgus. We sought to identify associated radiographic findings in patients where lesser toes follow the great toe in hallux valgus and deviate laterally. Methods: The weight-bearing, anteroposterior foot radiographs of 24 female hallux valgus feet with laterally deviated lesser toes (group L), 34 female hallux valgus feet with normal lesser toes (group H), and 43 normal female feet (group N) were selected for the study. A 2-dimensional coordinated system was used to analyze the shapes and angles of these feet by converting each dot made on the radiographs onto X and Y coordinates. Diagrams of the feet in each group were drawn for comparison. The hallux valgus angle, lateral deviation angle of the second toe, intermetatarsal angles, toe length, metatarsal length, and metatarsus adductus were calculated according to the coordinates of the corresponding points. Results: The mapping showed the bases of the second, third, and fourth toe in group L shifted laterally away from their corresponding metatarsal head (P < .001). The mean 2-3 intermetatarsal angles were: group L, H, N = 7.7 ± 2.6, 4.3 ± 1.9, 4.3 ± 1.3 degrees, respectively (P < .001); mean 3-4 intermetatarsal angles were, for groups L, H, N = 7.3 ± 2.3, 6.1 ± 2.1, 6.3 ± 1.4 degrees, respectively (P < .05). Larger hallux valgus angles (P < .001), more adducted first metatarsal (P < .05), and divergent lateral splaying of the lesser metatarsals (P < .001) were found in group L. Conclusion: Larger 2-3 and 3-4 intermetatarsal angles, larger hallux valgus angle, more adducted first metatarsal, and divergent lateral splaying of the lesser metatarsals were associated with lateral deviation of the lesser toes in hallux valgus. Level of Evidence: Level III, comparative study.

Original languageEnglish
Pages (from-to)664-672
Number of pages9
JournalFoot and Ankle International
Volume36
Issue number6
DOIs
Publication statusPublished - 2015 Jun 6
Externally publishedYes

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Hallux Valgus
Toes
Metatarsal Bones
Foot
Hallux
Weight-Bearing

Keywords

  • hallux valgus
  • lesser toes
  • mapping system

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Why do lesser toes deviate laterally in hallux valgus? A radiographic study. / Roan, Li Yi; Tanaka, Yasuhito; Taniguchi, Akira; Tomiwa, Kiyonori; Kumai, Tsukasa; Cheng, Yuh Min.

In: Foot and Ankle International, Vol. 36, No. 6, 06.06.2015, p. 664-672.

Research output: Contribution to journalArticle

Roan, Li Yi ; Tanaka, Yasuhito ; Taniguchi, Akira ; Tomiwa, Kiyonori ; Kumai, Tsukasa ; Cheng, Yuh Min. / Why do lesser toes deviate laterally in hallux valgus? A radiographic study. In: Foot and Ankle International. 2015 ; Vol. 36, No. 6. pp. 664-672.
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AU - Roan, Li Yi

AU - Tanaka, Yasuhito

AU - Taniguchi, Akira

AU - Tomiwa, Kiyonori

AU - Kumai, Tsukasa

AU - Cheng, Yuh Min

PY - 2015/6/6

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N2 - Background: Hallux valgus foot with laterally deviated lesser toes is a complex condition to treat. Ignoring the laterally deviated lesser toes in hallux valgus might result in unsatisfactory foot shape. Without lateral support of the lesser toes, it might increase the risk of recurrence of hallux valgus. We sought to identify associated radiographic findings in patients where lesser toes follow the great toe in hallux valgus and deviate laterally. Methods: The weight-bearing, anteroposterior foot radiographs of 24 female hallux valgus feet with laterally deviated lesser toes (group L), 34 female hallux valgus feet with normal lesser toes (group H), and 43 normal female feet (group N) were selected for the study. A 2-dimensional coordinated system was used to analyze the shapes and angles of these feet by converting each dot made on the radiographs onto X and Y coordinates. Diagrams of the feet in each group were drawn for comparison. The hallux valgus angle, lateral deviation angle of the second toe, intermetatarsal angles, toe length, metatarsal length, and metatarsus adductus were calculated according to the coordinates of the corresponding points. Results: The mapping showed the bases of the second, third, and fourth toe in group L shifted laterally away from their corresponding metatarsal head (P < .001). The mean 2-3 intermetatarsal angles were: group L, H, N = 7.7 ± 2.6, 4.3 ± 1.9, 4.3 ± 1.3 degrees, respectively (P < .001); mean 3-4 intermetatarsal angles were, for groups L, H, N = 7.3 ± 2.3, 6.1 ± 2.1, 6.3 ± 1.4 degrees, respectively (P < .05). Larger hallux valgus angles (P < .001), more adducted first metatarsal (P < .05), and divergent lateral splaying of the lesser metatarsals (P < .001) were found in group L. Conclusion: Larger 2-3 and 3-4 intermetatarsal angles, larger hallux valgus angle, more adducted first metatarsal, and divergent lateral splaying of the lesser metatarsals were associated with lateral deviation of the lesser toes in hallux valgus. Level of Evidence: Level III, comparative study.

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