Клинические исследования стопы и голеностопного сустава

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Novel Ultrasonographic Method to Assess Metatarsal Heads Heights in Hallux Valgus Patients: Pre and Post-Surgical Evaluation after First Metatarsal Osteotomy

Stoppino LP, Cassano A, Cleopazzo E, Moffa AP, Specchiulli LP, Gallo C, Vinci R, Vittore D and Macarini L

Objective: Hallux valgus is a forefoot deformity usually revealed with a weight-bearing radiograph of the foot. The aim of this study is to describe a new ultrasonographic method to assess metatarsal heads in hallux valgus patients.

Methods: We enrolled 38 patients with hallux valgus candidates to surgery. We assessed the ultrasonographic distance between the inferior surface of all metatarsal heads and support plane, before and after surgery. Moreover, we assessed the American Orthopaedic Foot and Ankle Society (AOFAS) clinical score before and after surgery.

Results: Our results showed a decrease of ultrasound distance for the first metatarsal head before and after surgery and an increase in all other distances of the remaining metatarsal heads before and after surgery. Finally, we showed significant differences between preoperatively and postoperatively clinical values.

Conclusion: The first metatarsal osteotomy should be able to restore the normal distribution of forefoot loading forces, hence reducing the associated metatarsalgia, as confirmed in this study. We suggest that our ultrasonographic method represent an accurate diagnostic tool in the pre and post-surgical evaluation of patients with hallux valgus, thus allowing a direct and reproducible measurement of metatarsal heads.