Surgical Pathology & Practice

Biography

Biography: Nihat Acar

Abstract

Background: The aetiology of hallux valgus is multifactorial in nature. The first metatarsocuneiform joint obliquity is a well-known factor in development of the deformity.

Purpose: The purpose of this radiological study is to assess the correlation of different medial cuneiform radiological measures on the severity of hallux valgus.

Methods: Full-weight bearing anteroposterior views of 152 feet with different clinical severity were obtained and were divided into four groups: without deformity, with mild, moderate and severe deformity. Three medial cuneiform angles were assessed. The first metatarsocuneiform angle, the first metatarsocuneiform slope angle and the medial cuneiform lateral tilt angle.

Results: The first metatarsocuneiform angle average values of group 1, 2, 3 and 4 were (25.16±5.74°, 27.38±6.14°, 30.27±5.62° and 34.28±6.81°) respectively. Statistical differences were detected between groups (1, 3) and (1, 4), P=0.034 and 0.001 respectively. The average values of the first metatarsocuneiform slope angle of groups 1, 2, 3 and 4 were (19.26±4.97°, 22.54±5.62°, 26.13±6.36° and 32.17±5.85°) respectively. Significant differences were detected between groups (1, 3) and (1, 4), P=0.04 and 0.023 respectively. Average values of the medial cuneiform lateral tilt angle of groups 1, 2, 3 and 4 were (80.85±4.49°, 74.56±5.28°, 62.38±6.34° and 58.78±6.25°) respectively. Statistical significances were detected between groups (1, 2), (1, 3) and (1, 4) with P=0.026, 0.018 and 0.001 respectively.

Conclusions: Increasing the medial cuneiform lateral tilt increases the first metatarsocuneiform articulation obliquity demonstrated by the increase in the first metatarsocuneiform slope angle which in term enhances the progression of varus deformity of the first metatarsal bone explained by the increase in the first metatarsocuneiform angle.