Abstract
The standard classification system used to measure the sesamoids in the evaluation
of hallux abductovalgus is a uniplanar description of a multiplanar deformity. Additionally,
it cannot accurately describe a true measure of sesamoid positional change in the
perioperative period because the first metatarsal is laterally transposed during corrective
surgery. The intended emphasis of this investigation is to evaluate the sesamoid position
in multiple planes relative to a stationary anatomical landmark following first metatarsal
osteotomy for the surgical correction of hallux abductovalgus deformity. A retrospective
radiographic review of 46 feet in 38 patients demonstrated statistically significant
(P < .001) differences between preoperative and postoperative values for the first intermetatarsal
angle, hallux abductus angle, sesamoid rotation angle, tibial sesamoid position, and
tibial sesamoid grade. However, there was no significant difference in the sesamoid
position in both the transverse (P = .07) and frontal (P = .29) planes when measured relative to the stationary second metatarsal. Based on
the preceding results, the appropriate expected surgical outcome of hallux abductovalgus
correction may be to relocate the first metatarsal on top of the relatively immobile
sesamoids.
Level of Clinical Evidence
Keywords
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References
- Observations on hallux valgus.J Bone Joint Surg Br. 1951; 33: 376-391
- Lateral shifting of the first metatarsal head in hallux valgus surgery: effect on sesamoid reduction.Foot Ankle Int. 2003; 24: 922-926
- Biplanar chevron osteotomy.Foot Ankle Int. 2002; 23: 792-798
- Crescentic proximal metatarsal osteotomy for moderate to severe hallux valgus: a mean 12.2 year follow-up study.Foot Ankle Int. 2001; 22: 817-822
- Tricorrectional bunionectomy for hallux abducto valgus. A comprehensive outcome study.J Am Podiatr Med Assoc. 1999; 89: 174-182
- Basal closing wedge osteotomy for correction of hallux valgus and metatarsal primus varus: 10- to 22-year follow-up.Foot Ankle Int. 1999; 20: 171-177
- Review of radiographic measurements following Austin bunionectomy.J Am Podiatr Med Assoc. 1998; 88: 290-294
- Modified Austin procedure for correction of hallux valgus.Foot Ankle Int. 1997; 18: 119-127
- Z-bunionectomy: retrospective long-term study.J Foot Ankle Surg. 1996; 35: 312-317
- Prospective, randomized comparison of proximal crescentic and proximal chevron osteotomies for correction of hallux valgus deformity.Foot Ankle Int. 1996; 17: 307-316
- The Kalish osteotomy. A review and retrospective analysis of 265 cases.J Am Podiatr Med Assoc. 1994; 85: 237-242
- The effect of hallux abducto valgus surgery on the sesamoid apparatus position.J Am Podiatr Med Assoc. 1999; 89: 551-559
- Pathologic anatomy of hallux abducto valgus.Clin Podiatr Med Surg. 1989; 6: 1-15
- Predicting articular erosion in hallux valgus: clinical, radiographic, and intraoperative analysis.J Foot Ankle Surg. 2005; 44: 13-21
- Axial radiographic evaluation in hallux valgus: evaluation of the transverse arch of the forefoot.J Orthop Sci. 2004; 9: 446-451
- Effect of proximal articular set angle-correcting osteotomies on the hallucal sesamoid apparatus: a cadaveric and radiographic investigation.J Foot Ankle Surg. 2001; 40: 366-373
- Assessing sesamoid subluxation: how good is the AP radiograph?.Foot Ankle Int. 1998; 19: 547-554
Martin DE, Pontious J. Introduction and evaluation of hallux abducto valgus. In McGlamry's Comprehensive Textbook of Foot and Ankle Surgery, pp 481-91, edited by AS Banks, MS Downey, DE Martin, SJ Miller, Lippincott, Williams and Wilkins, Philadelphia, 2001.
Jahss MH. Disorders of the hallux and the first ray. In Disorders of the Foot and Ankle. Medical and Surgical Management, pp 943–1106, edited by MH Jahss, W.B. Saunders Company, Philadelphia, 1991.
Myerson MS. Hallux valgus. In Foot and Ankle Disorders, pp 213–288, edited by MS Myerson, W.B. Saunders Company, Philadelphia, 2000.
Coughlin MJ, Mann RA. Hallux valgus. In: Surgery of the Foot and Ankle, pp 183-362, edited by MH Coughlin, RA Mann, CL Saltzman, Mosby Elsevier, Philadelphia, 2007.
- New radiographic analysis of sesamoid rotation in hallux valgus: comparison with conventional evaluation methods.Foot Ankle Int. 2002; 23: 811-817
- Effect of metatarsophalangeal joint position on the reliability of the tangential sesamoid view in determining sesamoid position.Foot Ankle Int. 2005; 26: 247-250
- Foot segmental relationships and bone morphology.in: Christman R.A. Foot and Ankle Radiology. Churchill Livingstone, St. Louis, MO2003: 272-300
Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
