[Truncated abstract] Hallux valgus (HV) is one of the most common foot deformities encountered in clinical practice. This complex deformity primarily affects the first metatarsophalangeal joint (MPJ), leading to altered foot structure and function. By virtue of the lateral displacement of the hallux on the first metatarsal, HV has the potential to influence adjacent joints of the foot. In doing so, function of the foot may be altered, and clinically this may result in abduction of the foot during the stance phase of gait. However the relationship between an abducted angle of gait (AOG) and HV has never been substantially examined. The purpose of this study is to investigate the relationship between HV and AOG, and determine if specific radiographic features are associated with the deformity or with a particular AOG. Such information would assist in understanding aetiological factors and the effects of intervention to treat the deformity ... Length and elevation of the first metatarsal were associated in subjects with HV, implying that length of the metatarsal may be related to whether or not it becomes elevated (R: 0.50, CI: 0.21, 0.71, P< 0.05). Similarly, an association was found between length of the first metatarsal and the amount of first MPJ dorsiflexion, suggesting perhaps length of the metatarsal has implications for first MPJ range of motion (R: -0.37, CI: -0.62, -0.04, P<0.05). However the amount of first MPJ dorsiflexion did not influence the AOG in HV subjects when compared to the control group. First MPJ dorsiflexion was also associated with the first intermetatarsal angle. Interestingly, the HV group alone did not show an association between the hallux abductus angle and the first intermetatarsal angle. The findings of this study are contrary to those suspected in clinical practice and alluded to in the literature. Despite the documented support for the biomechanical causes of HV, an abducted AOG was not significantly different in HV subjects when compared to controls. Possible explanations may have related to limitations of the present study including the size and gender demographics of the sample population, and greater variability in normal AOG ranges than reported in the literature. The present study indicated a possible need to gather information regarding foot dominance and leg length; factors extrinsic to the foot capable of influencing transverse plane orientation of the foot; and, the influence of symptoms and subsequent compensatory mechanisms adopted during gait.
| Identifer | oai:union.ndltd.org:ADTP/221090 |
| Date | January 2005 |
| Creators | Taranto, Julie |
| Publisher | University of Western Australia. School of Surgery and Pathology |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | Copyright Julie Taranto, http://www.itpo.uwa.edu.au/UWA-Computer-And-Software-Use-Regulations.html |
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