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. 2009 May 14:2:15.
doi: 10.1186/1757-1146-2-15.

A geometric analysis of hallux valgus: correlation with clinical assessment of severity

Carlos Piqué-Vidal  1 , Joan Vila
Affiliations

A geometric analysis of hallux valgus: correlation with clinical assessment of severity

Carlos Piqué-Vidal et al. J Foot Ankle Res. .

Abstract

Background: Application of plane geometry to the study of bunion deformity may represent an interesting and novel approach in the research field of hallux valgus. For the purpose of contributing to development of a different perspective in the assessment of hallux valgus, this study was conducted with three objectives: a) to determine the position on the intersection point of the perpendicular bisectors of the longitudinal axes of the first metatarsal and proximal phalanx (IP), b) to correlate the location of this point with hallux valgus deformity according to angular measurements and according to visual assessment of the severity carried out by three independent observers, and c) to assess whether this IP correlated with the radius of the first metatarsophalangeal arc circumference.

Methods: Measurements evaluated were intermetatarsal angle (IMA), hallux valgus angle (HVA), and proximal phalangeal articular angle (PPAA). The Autocad(R) program computed the location of the IP inside or outside of the foot. Three independent observers rated the severity of hallux valgus in photographs using a 100-mm visual analogue scale (VAS).

Results: Measurements of all angles except PPAA showed significantly lower values when the IP was located out of the foot more distantly and vice versa, significantly higher values for severe deformities in which the IP was found inside the foot (p < 0.001). The IP correlated significantly with VAS scores and with the length of the radius of the circle that included the first metatarsophalangeal arc circumference (p < 0.001)

Conclusion: The IP is a useful indicator of hallux valgus deformity because correlated significantly with IMA and HVA measurements, VAS scores obtained by visual inspection of the degree of deformity, and location of the center of the first metatarsophalangeal arc circumference.

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Figures

Figure 1
Figure 1
Measurements of the hallux valgus angle (HVA), the first intermetatarsal angle (IMA), and the proximal phalangeal articular angle (PPAA).
Figure 2
Figure 2
Position on the intersection point (IP) of the perpendicular bisectors of the longitudinal axes of the first metatarsal shaft (line segment a-a') and proximal phalanx (line segment b-b'). Distance length (DL) is the line segment from IP to a/b.
Figure 3
Figure 3
Position of the center of the circle formed by the first metatarsophalangeal arc circumference.
Figure 4
Figure 4
Representative image of hallux valgus deformity.
Figure 5
Figure 5
Position of the intersection point (IP) (left) and of the center of the first metatarsophalangeal arc circumference (right) inside the foot in a case of severe hallux valgus deformity.
Figure 6
Figure 6
Position of the intersection point (IP) and of the center of the first metatarsophalangeal arc circumference (right) out of the foot but within a distance of a foot width in a case of moderate hallux valgus deformity.
Figure 7
Figure 7
Correlation between DL and radius of the first metatarsophalangeal arc circumference.
See this image and copyright information in PMC

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