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Topic: Valgus deformity

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Varus deformity

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	Research and Publications
		The radiographic appearance and therefore the pathogenesis of juvenile hallux valgus may be different because the deformity tends to be one of joint angulation manifested by an increase in the DMAA as opposed to true joint instability.
		Haines RW, McDougall A: The anatomy of hallux valgus.
		Kilmartin TE, Wallace WA: The significance of pes planus in juvenile hallux valgus.
	www.mdmercy.com /footandankle/research_pubs/pressItem63.html (4546 words)

	ABC's of MHE - Multiple Exostoses and the Lower Limb
		This leads to a valgus deformity (knock-kneed) of the upper tibia and a valgus deformity of the ankle (tilted outward).
		Valgus of the neck of the femur is usually symmetric and therefore does not lead to a leg length discrepancy.
		This deformity is usually related to tethering or locking of the soft tissues around the knee by distal femoral or proximal tibial osteochondromas.
	www.mhecoalition.com /ABCs_LowerLimb.html (3318 words)

	Foot and Ankle Conditions: Hallux Valgus (Bunion Deformity)
		The decision to perform one type of surgery or another is based upon the extent and magnitude of the bunion deformity, the presence of arthritis in the big toe joint, and the space between the first and second metatarsals, which is called the intermetatarsal angle.
		For very severe bunion deformities where there is considerable angulation between the first and second metatarsals an osteotomy of the metatarsal may not be sufficient, and for these patients, the joint between the first metatarsal and the cuneiform bone is fused with screws, called the Lapidus procedure.
		The deformity is corrected through the joint either with a fusion of the joint or by removing a portion of the joint (an arthroplasty).
	footandankle.mdmercy.com /conditions/bigtoe/hallux_valgus.html (1003 words)

	eMedicine - Bunion : Article by Richard T Laughlin, MD (Site not responding. Last check: 2007-10-20)
		Hallux valgus (HV), with its accompanying bunion, is a common deformity of the forefoot.
		Deformity at this level contributes to an increased valgus deformity of the first toe; however, the deformity is expressed at the IPJ rather than the MTPJ.
		Moderate bunion deformity with an intermetatarsal angle of 14° and a hallux valgus angle of 28°.
	www.emedicine.com /orthoped/topic467.htm (6590 words)

	NGC - NGC Summary
		Hallux valgus is considered to be a progressive condition and patients present with varied degrees of deformity from mild enlargement of the metatarsal head to severe dislocation of the first MTP joint.
		Although the appearance of the deformity may not be significant, there is often deviation of the joint and medial enlargement of the first metatarsal head.
		In summary, hallux valgus deformity is an inherited, progressive deformity often associated with certain foot types, with symptoms aggravated by shoe wear.
	www.guideline.gov /summary/summary.aspx?doc_id=3849&nbr=3064 (4952 words)

	A Review of Tailor's bunion with an Emphasis on Surgical Options (Site not responding. Last check: 2007-10-20)
		Whilst a bunion deformity of the first ray may take precedence in size and physical disfigurement; it may be no more painful or inconvenient than a fifth ray bunion for the patient.
		The ratio of literature between bunions and bunionettes would suggest that a tailor's bunion is of little significance in comparison to a hallux valgus deformity.
		The authors conclude that an increased 4/5 intermetatarsal angle is suggestive of a functional cause as the primary aetiology; the increased lateral bowing suggestive of a structural cause as the primary aetiology.
	podiatry.curtin.edu.au /encyclopedia/benson (3299 words)

	Journal of Arthroplasty and Arthroscopic Surgery (Site not responding. Last check: 2007-10-20)
		In hallux valgus interphalangeus with an increased articular angle of the proximal phalanx (PPAA), a proximal phalangeal osteotomy is indicated.
		The results of hallux valgus treatment achieved with this differentiated approach demonstrate that the deformity must be corrected where and how it occurs, and that not all forms of hallux valgus can be treated with the same surgical procedure.
		In hallux valgus, lateral subluxation of the proximal phalanx on the metatarsal head is commonly seen on the weight-bearing anteroposterior radiograph.
	arthroplasty-arthroscopy.mc.metu.edu.tr /2000/no2-16.html (4427 words)

	Research and Publications
		In the absence of hallux valgus deformity and sesamoid rotation the lateral sesamoid ligament could be longitudinally incised with the blade inserted between the metatarsal head and the lateral sesamoid (Fig 2).
		In hallux valgus deformity, there is a medial deviation of the metatarsal head, which away from the confines of the sesamoid complex, while the great toe deviates laterally.
		In the presence of chronic hallux valgus deformity, it is not uncommon for the sesamoids to have osteophytes on their margins.
	footandankle.mdmercy.com /research_pubs/pressItem93.html (4018 words)

	Bunions
		Hallux Abducto Valgus refers to a deformity associated with a bunion in which the big toe (Hallux) is angled excessively toward the 2nd toe.
		The bunion prominence is often caused by some enlargement of the head of the 1st metatarsal bone as well as the position of the 1st metatarsal bone as it protrudes from the side of the foot.
		Thus, a bunion deformity is usually a combination of the abnormal position of the 1st metatarsal bone as well as an enlargement of its 'head'.
	www.users.interport.net /i/b/ibeiser/bunions.htm (2233 words)

	The Foot in Myelomeningocele: Some practical questions and answers. (Site not responding. Last check: 2007-10-20)
		A residual forefoot adductus deformity in an idiopathic club foot may be addressed, for instance, by transfer of part of the tibialis anterior tendon from its dorso-medial insertion to a dorso-lateral site.
		In the myelomeningocele patient the calcaneal deformity is due to unopposed contracture or spasticity of the anterior muscles, with a varus component if tibialis anterior dominates and a valgus component in the peroneals are relatively strong or spastic ( FIG 4).
		A pure hindfoot cavus deformity is uncommon and can be addressed by a lateral closing wedge osteotomy of the calcaneus or a lateral sliding calcaneal osteotomy.
	www.iol.ie /~rcsiorth/journal/volume2/march/spina.htm (2774 words)

	Case report: ANGULAR LIMB DEFORMITY IN A GIRAFFE CALF
		The center of the valgus was at the carpus (Fig.
		Valgus and varus deformity are rare in cattle but are quite common in horses.
		Leg deformity in young calves is mostly associated with congenital contraction of the tendons, whereas in foals other causes had been reported, among which are rapid weight gain in foals of the heavy breeds to a point that the calcification of the carpal bones is not strong enough to support their weight and A.L.D appears.
	www.isrvma.org /article/56_4_4.htm (623 words)

	Response of Eight Knee Orthoses to Valgus, Varus and Axial Rotation Loads - Journal of Prosthetics and Orthotics, 1990 ...
		Valgus, varus and axial rotation torques were applied to the test apparatus and corresponding angular deformities were measured.
		Valgus and varus force was applied with the tensiometer at a point corresponding to the apex of the lateral malleolus (Figure 5).
		The mean (+/- sd) valgus angle of deformity ranged from a low of 0 degrees for the Polyaction, Lerman, ECKO, Analog and Pro Am orthoses at 65 inch pounds of torque to a high of 46.7 degrees (+/- 1.16) for the ECKO knee orthoses at 650 inch-pounds of torque (Table 2).
	www.oandp.org /jpo/library/1990_04_274.asp (4552 words)

	Anatomy Modules: Radiographic Evaluation of Hallux Valgus
		Hallux valgus is not synonymous with bunion, which is derived from the same root as "bun" or "bunch", and means an area of swelling.
		The etiology of hallux valgus is somewhat controversial.
		As the first toe migrates more and more to valgus, it presses against the second toe, and may aggravate dorsal clawing of the second toe, which is usually initiated by overload of the second metatarsal and synovitis of the metatarsophalangeal joint.
	www.rad.washington.edu /anatomy/modules/HalluxValgus/HalluxValgus.html (946 words)

	[No title] (Site not responding. Last check: 2007-10-20)
		In its denial of service connection for a bilateral foot condition, the RO noted that the veteran's right foot injury appeared to be acute and transitory, inasmuch as he did not suffer any appreciable bone or soft tissue damage, and made no further complaints concerning this injury during the remainder of service.
		Upon examination, pes planus with hallux valgus was found bilaterally, with a severe deviation of the great toes, and slight overriding of the second toe.
		Furthermore, the veteran had more than six years of active service before the presence of a hallux valgus deformity was noted, despite the fact that the veteran was treated for various injuries prior to this finding, and the presence of such a foot deformity was not found.
	www.va.gov /vetapp/files2/9412836.txt (1383 words)

	Orthotic Management of Valgus Foot Deformity in Children with Spina Bifida \| JACPOC Library, 1986
		A case presentation demonstrates the use of a polypropylene ankle-foot orthosis for control of valgus feet in a child with spina bifida.
		Progressive valgus deformity leads to an increasingly unstable and energy-consuming gait, with flexion at the hips and knees and the possibility of tissue trauma.
		Increased stability of the feet leads to extension at the hips and knees and to less effort being required in ambulation.
	jacpoc.oandp.com /library/1986_03_055.asp (229 words)

	Valgus Lower-Limb Deformity in the Juvenile Amputee \| JACPOC Library, 1984
		Valgus Lower-Limb Deformity in the Juvenile Amputee
		The valgus deformity, existing in congenital as well as acquired amputations, has manifested itself as patellar subluxation and knee-flexion contracture and in a wide range of abnormalities.
		The pitfalls of diagnosis and treatment were discussed and conclusions based on considerable clinical experience were drawn with special attention directed toward the child in the physiologic valgus age range.
	jacpoc.oandp.com /library/1984_03_064.asp (149 words)

	AllRefer Health - Bunion Removal (Bunionectomy, Hallux Valgus Correction) - Surgery & Procedures
		Bunion removal is the surgical treatment of a deformity of the bones of the big toe and foot ( bunion).
		A bunion is a painful deformity of the bones and joint between the foot and the big toe.
		The deformed joint and bones are repaired, and the bones are stabilized with a pin and/or cast.
	health.allrefer.com /health/bunion-removal-info.html (411 words)

	KORT - Kentucky Orthopedic Rehab Team (Site not responding. Last check: 2007-10-20)
		Hallux valgus is a condition that affects the joint at the base of the big toe.
		Finally, increasing deformity begins to displace the second toe upward and may create a situation where the second toe is constantly rubbing on the shoe.
		In the early stages of hallux valgus, converting from a shoe with a pointed toe to a shoe with a wide forefoot (or toe box), may arrest the progression of the deformity.
	www.kort.com /foot/footbunions.asp (1657 words)

	A Patient's Guide to Foot and Ankle Problems - Bunion (Site not responding. Last check: 2007-10-20)
		Hallux Valgus is a condition which affects the joint at the base of the big toe.
		Hallux is the medical term for big toe, and valgus is an anatomic term that means the deformity goes in a direction away from the midline of the body.
		In the early stages of hallux valgus, converting from a pointed toe shoe to a wider box toe shoe may arrest the progression of the deformity.
	www.castleortho.com /group/foot/bunion/bunion.html (1126 words)

	Breakthroughs in Bracing - February 2001 - Rehab Management - The Interdisciplinary Journal of Rehabilitation
		When the lateral compartment of the knee is compromised, for example, with a valgus type deformity, there is a subsequent increase in the pain and pressure on the lateral knee compartment.
		Alignment deformities on the weight-bearing surfaces in the knee tend to be progressive.
		Focusing on a varus deformity or a medial impinged compartment, forces must be applied to the medial thigh and calf while a counterforce is applied by the placement of the knee joint itself by using condylar pads.
	www.rehabpub.com /features/22001/2.asp (1840 words)

	eMedicine - Hallux Valgus : Article by Crista J Frank, DPM (Site not responding. Last check: 2007-10-20)
		In the pathologic hallux valgus, the crista is often eroded as a result of the laterally deviated position of the sesamoids.
		However, experience has shown that this is not a primary procedure to be used for the repair of hallux valgus deformity, as it does not directly restore the sesamoid position, address adaptive changes of the cartilage of the metatarsal phalangeal joint, or correct metatarsal deviations.
		In: Hallux Valgus, Allied Deformities of the Forefoot and Metatarsalgia.
	www.emedicine.com /orthoped/topic126.htm (7093 words)

	Journal of Bone and Joint Surgery: Replacement arthroplasty of the valgus knee: A modified lateral capsular approach ...
		knees with valgus deformity than in those in varus, usually because of swelling, poor wound healing and stiffness, instability, recurrent valgus deformity and poor patellar tracking.
		A technique for replacement TKR of valgus knees using a lateral capsular approach was described several years ago, but was not routinely adopted because of the difficulties with and complexity of the procedure which included deliberate elevation of the tibial tubercle.
		If there is a correctable valgus deformity, subperiosteal elevation of the iliotibial band and the lateral capsule should not continue laterally beyond the anterior half of the tibial circumference.
	www.findarticles.com /p/articles/mi_qa3767/is_199809/ai_n8821872 (1543 words)

	Heel spurs (Site not responding. Last check: 2007-10-20)
		An individual with the lower legs angulating inward, a condition called genu valgus or "knock knees," can have a tendency toward excessive pronation.
		It is not recommended to attempt working through the pain, as this can change a mild case of heel spurs and plantar fascitis into a long lasting and painful episode of this condition.
		Deformity in which the legs are curved inward so that the knees are close together, nearly or actually knocking as a person walks with ankles widely apart of each other.
	www.chclibrary.org /micromed/00050510.html (1275 words)

	PodiatryNetwork.com - Bunions (Site not responding. Last check: 2007-10-20)
		In the case of mild to moderate bunion deformities the bone cut is most often performed at the neck of the metatarsal (near the joint).
		As the deformity increases, there is an abnormal pull of certain tendons, which leads to the drifting of the great toe toward the 2nd toe.
		Functional foot orthotics, by controlling abnormal pronation, reduces the deforming forces leading to bunions in the first place.
	www.podiatrynetwork.com /r_bunions.cfm (973 words)

	Post Traumatic Tibial Valga, The Alfred I. duPont Institute
		Upon removal of the cast a slight valgus deformity was noted.
		Four months after the fracture, progressive valgus deformity was noted and the patient was referred to the duPont Institute for evaluation.
		Valgus deformity in excess of 15 degrees is less likely to spontaneously improve according to Jackson.
	gait.aidi.udel.edu /res695/homepage/pd_ortho/educate/clincase/tibial.htm (476 words)

	South Australian Orthopaedic Registrars' Notebook
		The apex of the medial longitudinal arch of the foot is collapsed inwards and medially The heel becomes valgus and the foot pronated
		The syndrome consists of a painful, rigid valgus deformity of both the fore and hind parts of the foot and peroneal muscle spasm but not true spasticity
		Muscle imbalance is not important primarily but contributes to further development of the deformity once established due to displacement of the abductor hallucis to the plantar aspect of the great toe, the tendons of FHL and EHL become bow-strung across the valgus angle and further contribute to an increasing deformity
	som.flinders.edu.au /FUSA/ORTHOWEB/notebook/regional/footankle.html (4703 words)

	JBJS -- Letters to the Editor for GugenheimJr and Brinker, 85 (7) 1229-1237
		We have enclosed four figures: Figure 1 shows a right femur with a juxtaaricular valgus deformity with three CORAs on the horizontal bisector line of the deformity angle at the level of the knee joint and the corresponding dome-shaped osteotomy for each CORA.
		If a lengthening CORA (instead of a neutral CORA) is chosen for a juxtaarticular distal femoral deformity, the type of deformity that we describe in our article, the offset of the bone at the osteotomy site will make it very difficult to pass an intramedullary nail, either retrograde or antegrade.
		However, we feel that the statements in the discussion "preexisting shortening of the bone cannot be corrected" by focal dome osteotomy of the distal femur and "the bone is not shortened as it is with a closing wedge osteotomy" are incorrect.
	www.ejbjs.org /cgi/eletters/85/7/1229 (744 words)

	AAOS On-Line Service - 2004 Annual Meeting Podium Presentations Distal Femoral Deformity in Children with Tibia Vara (Site not responding. Last check: 2007-10-20)
		Distal femoral deformity has not been measured in a large series of patients with different forms of tibia vara.
		Only 1 extremity was noted to have distal femoral valgus and this represented a difference of only 2 degrees from the contralateral normal side.
		Distal femoral valgus deformity is most often observed as an apparent deformity secondary to abduction of the hip as the child brings the foot to the midline of weight-bearing.
	www.aaos.org /wordhtml/anmt2004/sciprog/264.htm (373 words)

	Video J Orthopaed -- Video 1002
		Because the number of factors and the pathologic changes vary in hallux valgus deformities, no single procedure can successfully treat all cases.
		Each hallux valgus deformity must be evaluated independently and the appropriate procedure or combination of procedures applied.
		In this segment, Roger A. Mann, M.D., surgically demonstrates a procedure versatile and effective for the treatment of a number of hallux valgus deformities.
	www.vjortho.com /cgi/content/abstract/1002 (479 words)

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