Metatarsus adductus increases risk of hallux valgus deformity

LONG BEACH, Calif. — Metatarsus adductus may increase the risk of the radiographic recurrence of hallux valgus deformity regardless of the surgical procedure performed, according to data presented at the American Orthopaedic Foot & Ankle Society Annual Meeting.

“The presence of metatarsal adductus increases the risk of radiographic recurrence of deformity by two times. You need to unmask the degree of deformity that truly exists at the first metatarsal space. You have to realign the lesser metatarsal either proximally, distally or both to prevent the recurrence of the deformity,” Amiethab Aiyer, MD, said here.

Aiyer and colleagues conducted a retrospective study to identify the prevalence of metatarsus adductus in approximately 600 patients who underwent surgery for symptomatic hallux valgus during a 10-year period. They assessed radiographic parameters, including hallux valgus angle, intermetatarsal angle and metatarsus adductus angle from initial and final radiographs. The researchers considered metatarsus adductus angles greater than 20° as abnormal and defined radiographic recurrence as hallux valgus deformity greater than 20°.

Amiethab Aiyer

Overall, the prevalence of metatarsus adductus was 29.2%. When Aiyer and colleagues looked at metatarsal adductus patients as a whole, they found a 25% incidence of lesser toe deformities among the entire group, inclusive of hammer toes and claw toes.

As for severity, 19% of the patients had a metatarsus adductus angle between 21° and 25°, 7% of the patients had a metatarsus adductus angle between 26° and 30°, and 1.3% of the patients had a metatarsus adductus angle between 31° and 35°. Overall, 1.9% of patients had a metatarsus adductus angle greater than 36°.

Recurrence rates of hallux valgus were 15% in patients without metatarsus adductus and 28.9% in patients with metatarsus adductus. Recurrence of the deformity did not differ between surgical procedures, according to study results. – by Kristine Houck, MA, ELS

Reference:

Aiyer A, et al. Evaluating the impact of metatarsus adductus on patients undergoing hallux valgus surgery. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 15-18, 2015; Long Beach, Calif.

Disclosure: Aiyer reports no relevant financial disclosures.