Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Hallux valgus angle as main predictor for correction of hallux valgus

Discussion in 'Foot Surgery' started by NewsBot, May 16, 2008.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1

    Members do not see these Ads. Sign Up.
    Hallux valgus angle as main predictor for correction of hallux valgusAxel R Deenik , Enrico de Visser , Jan-Willem K Louwerens , Maarten de Waal Malefijt , Frits F Draijer and Rob A de Bie
    BMC Musculoskeletal Disorders 2008, 9:70doi:10.1186/1471-2474-9-70; Published: 15 May 2008
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. drsarbes

    drsarbes Well-Known Member

    I have to admit I have no idea what this paper is suggesting.
    Can someone please explain this.
    Thanks
    Steve
     
  4. Steve, I don't know much about surgery, but I'm ok with predictive modelling. The paper appears to be suggesting that for the type of surgery performed the preoperative hallux valgus angle (HVA) predicts the post-operative angle obtained at follow-up. That is, a significant proportion of the the variance in post-operative angle was accounted for by the pre-op angle in the population studied. In other words, the pre-op HVA is significant in the post-op HVA obtained. So if we had their model we could measure the pre-op HVA in one of your patients, pump the numbers through the model and know before we performed the type of surgery described what the angle would be in this patient, within statistical limits, two years post-op, without having performed that surgery.Like I said, I'm no surgeon, but I guess this would help you decide whether this specific procedure was the way to go for the patient or not. This assumes that your outcomes would match those of the surgeon in the study- they may, or may not.

    While the pre-operative IMA and DMAA do not predict the postoperative HVA- in other words, if you are performing this type of surgery, these angles have little to do with the outcome. So if you are doing this type of surgery they aren't important??????;)
     
    Last edited: May 19, 2008
  5. drsarbes

    drsarbes Well-Known Member

    Thanks Simon, I appreciate your taking the time to reply.
    I guess what I'm confused about is that the osteotomy or procedure performed often depends on the HVA (an angle formed by the first met and the Prox phalanx).
    One can put the toe (in relation to the metatarsal) pretty much wherever you'd like to. I try to place it in an anatomic position!
    I guess what I still don't understand is why this angle would not be corrected completely by their procedure of choice.
    Steve
     
  6. They're not saying that it isn't; what they are saying is the pre-op predicts the post-op, i.e. correlation. Are you sure your immediate post-op position is maintained two years later?
     
  7. drsarbes

    drsarbes Well-Known Member

    "Are you sure your immediate post-op position is maintained two years later?"
    I like to think so. The only time I normally tell patients that their hallux may migrate over is when they have a very short first metatarsal and or metadductus with the remaining toes also in varus, otherwise, yes, I expect the hallux to look good in two years (or ten for that matter)

    OK, I think I understand what they are trying to do. I just find it curious. If this particular procedure is not giving them long standing correction when the HVA is high, then they are not performing the correct procedure! And they performed it anyway to fulfill the study!
    Is it me or does this sound , well, "curious"


    Steve
     
  8. Peter

    Peter Well-Known Member

    Is the hallux valgus angle the same as the Hallux abductus angle (1st MP angle) ?
     
  9. Lee

    Lee Active Member

    Peter -
    The hallux valgus angle is an angle formed between the longitudinal bisection of the proximal phalanx of the hallux and the longitudinal bisection of the first metatarsal. I seem to remember that its less repeatable than the IM angle, probably because forming the longitudinal bisection of the proximal phalanx of the hallux is a bit more variable than on a longer bone (usually with less rotation) such as a metatarsal where it's a bit easier to repeatedly define reference points on your x-ray.
     
  10. Peter

    Peter Well-Known Member

    Thanks Lee, it appears to be the same, just different nomenclature.
     
Loading...

Share This Page