Hallux valgus in pedobarographic evaluation

Author(s): Elżbieta Szczygieł, Katarzyna Gajda, Joanna Golec, Aneta Bac, Anna Marchewka, Jerzy Walocha, Edward Golec

Introduction. Due to its multifactoral and still partially obscure aetiology, hallux vulgus represents a significant diagnostic and treatment problem. Most often, conservative treatment does not bring the expected results, however, if undertaken early, it may curb further deformation. If secondary anatomical changes are present, surgery is the best treatment method. Many authors emphasise that an important factor in the progress of the disease is incorrect distribution of pressure on the instep. In consequence, pedobarographic examinations, which allow for early detection of possible malfunctions, are increasingly often used in diagnostic and prognostic assessment of feet with hallux vulgus. Objective. The study aims to present a comparative analysis of the distribution of pressure on the instep of feet with abnormal inward leaning of the great toe, and healthy feet. Research material and method. The study was conducted on a group of 37 people (70 feet) diagnosed with hallux vulgus. They were compared with a control group of 10 people (20 feet), meeting all the criteria valid for healthy feet. The examination of the distribution of instep pressure was performed using a PEL 39 pedobarographic platform. In order to analyse the distribution of pressure, the feet were divided into Kernozek zones. The results obtained in the course of the pedobarographic examinations were analysed on the basis of the following criteria of a transverse foot arch: FF2 < FF1 and FF3; for oblong arch M < H and M < FF1, FF2, FF3; for three points of support for the foot: the maximum pressure values had to be highest below the heel in the H zone and at the same time, conditions for the oblong and transverse arches also had to be met. Results. The results obtained in the study ascertained that in a group of 70 feet with hallux vulgus, 61 feet did not meet the criteria for a transverse arch of the foot. In the case of 37 of the examined feet, the correct oblong arch was not present. As many as 68 feet did not have three points of support. Conclusions. 1. When compared with healthy feet, feet with hallux vulgus exhibit a different distribution of pressure on the instep; the pressure is significantly higher below the head of the 2nd and 3rd metatarsal bones. 2. A vast majority of the feet studied that had bunion deformities do not meet the criteria for transverse and oblong arches or have a system of three points of support.