Abstract
The hypermobility theory of the first ray is the reason for the popularization of
procedures such as the modified Lapidus procedure involving arthrodesis of the first
tarsal–metatarsal joint for correction of hallux valgus deformity. Although many studies
have involved motion of the first ray in hallux valgus patients, the presence and
clinical significance of hypermobility in the first ray remains controversial. We
performed a systematic review and meta-analysis to evaluate the difference in the
first ray range of motion between patients with or without hallux valgus deformity.
The databases used for the present review included Ovid EMBASE, Ovid MEDLINE, CINAHL,
and the Cochrane Database. We searched for comparative studies that had evaluated
the motion of the first ray in patients with or without hallux valgus. After screening
for inclusion and exclusion criteria, we identified 3 studies that were relevant to
our study question. All 3 studies showed more first ray motion in the hallux valgus
group. Our quantitative synthesis showed a mean difference in the range of motion
of the first ray of 3.62 mm (95% confidence interval 2.26 to 4.98) between those with
and without hallux valgus deformity. Thus, we found statistically significantly increased
first ray motion in patients with hallux valgus deformity compared with those without
hallux valgus deformity. However, the clinical significance of this small amount of
increased sagittal plane motion as a response to or a cause of hallux valgus remains
unanswered.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: July 18, 2017
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
Published by Elsevier Inc. On behalf of the American College of Foot and Ankle Surgeons.
