Research Article
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The Effect of Night Splint Use on Hallux Valgus Angle and Functional Scores in Patients with Hallux Valgus Deformity

Year 2018, , 584 - 591, 27.12.2018
https://doi.org/10.17098/amj.501715

Abstract

Objectives: It was aimed to investigate the change in HV angles
and functional scores of the patients with Hallux Valgus (HV) deformity during
their follow-up with the conservative treatment method, i.e. night splint, in
our clinic.



Materials and Methods: The study group of this retrospective study was
constituted by patients diagnosed with HV deformity who presented to the
Orthopedics and Traumatology Clinic of Ankara Yıldırım Beyazıt University
Yenimahalle Training and Research Hospital between January 2017 – May 2018.
Files of 227 patients included in the study group were retrospectively screened.
Among these patients, the change in HV angle and functional scores were noted
for the patients who had an HV angle higher than 25 degrees in foot radiographs
and who were conservatively treated with night splints for 6 months (n=76) in
order to conduct pre- and post-treatment comparison.



Results: In our study group (n=76), it was observed that the
leading causes of presenting with HV deformity, which was more common in the
female population (n=68), consisted of pain (53.94%) followed by cosmetic
impairment (46.05%), and that HV more frequently showed symptoms in patients
working in a standing position (n=33 / 75.75%). There was no significant
decrease in HV angles (p=0.563) but a significant improvement in functional
scores (pain: p=0.022 and function: p=0.031) after using night splints for 6
months.



Conclusion:
Effective and long-term use of night splints in middle aged and older patients,
who were diagnosed with HV deformity and have high HV angles, provided a
partial decrease in HV angles as well as a significant improvement in
functional scores. Long-term use of night splints can be beneficial for
increasing the quality of life in patients who do not desire to receive
surgical treatment despite having high HV angles.

References

  • 1. Mann RA, Coughlin MJ. Hallux valgus--etiology, anatomy, treatment and surgical considerations. Clin Orthop Relat Res 1981;157:31-41.
  • 2. Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int 2007;28(7):759-77.
  • 3. Spink MJ, Menz HB, Lord SR. Distribution and correlates of plantar hyperkeratotic lesions in older people. J Foot Ankle Res 2009;2:8.
  • 4. Joseph TN, Mroczek KJ. Decision making in the treatment of hallux valgus. Bull NYU Hosp Jt Dis 2007;65(1):19-23.
  • 5. Solan MC, Lemon M, Bendall SP. The surgical anatomy of the dorsomedial cutaneous nerve of the hallux. J Bone Joint Surg Br 2001;83(2):250-2.
  • 6. Brahm SM. Shape of the first metatarsal head in hallux rigidus and hallux valgus. J Am Podiatr Med Assoc 1988;78(6):300-4.
  • 7. Helal B. Surgery for adolescent hallux valgus. Clin Orthop Relat Res 1981;157:50-63.
  • 8. Coughlin MJ. Hallux valgus. J Bone Joint Surg Am, 1996;78(6):932-66.
  • 9. Pique-Vidal C, MT Sole, J Antich, Hallux valgus inheritance: pedigree research in 350 patients with bunion deformity. J Foot Ankle Surg 2007;46(3):149-54.
  • 10. Kato T, Watanabe S. The etiology of hallux valgus in Japan. Clin Orthop Relat Res, 1981;157:78-81.
  • 11. Shereff MJ, Pathophysiology, anatomy, and biomechanics of hallux valgus. Orthopedics 1990;13(9):939-45.
  • 12. Crawford VL. Conservative podiatric medicine and disability in elderly people. J Am Podiatr Med Assoc 1995;85(5):255-9.
  • 13. Benvenuti F, Ferrucci L, Guralnik JM, Gangemi S, Baroni A. Foot pain and disability in older persons: an epidemiologic survey. J Am Geriatr Soc 1995;43(5):479-84.
  • 14. Dunn JE, Link CL, Felson DT, Crincoli MG, Keysor JJ, McKinlay JB. Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol, 2004;159(5):491-8.
  • 15. Cho NH, Kim S, Kwon DJ, Kim HA. The prevalence of hallux valgus and its association with foot pain and function in a rural Korean community. J Bone Joint Surg Br 2009;91(4):494-8.
  • 16. Nork SE, Coughlin RR. How to examine a foot and what to do with a bunion. Prim Care 1996;23(2):281-97.
  • 17. Ferrari J, Higgins JP, Williams RL. Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database Syst Rev 2000(2): p. CD000964.
  • 18. Garrow AP, Papageorgiou A, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ. The grading of hallux valgus. The Manchester Scale. J Am Podiatr Med Assoc 2001;91(2):74-8.
  • 19. Srivastava S, Chockalingam N, El Fakhri T. Radiographic angles in hallux valgus: comparison between manual and computer-assisted measurements. J Foot Ankle Surg 2010;49(6):523-8.
  • 20. Srivastava S, Chockalingam N, El Fakhri T. Radiographic measurements of hallux angles: a review of current techniques. Foot (Edinb) 2010;20(1):27-31.
  • 21. LaPorta GA, Nasser EM, Mulhern JL, Malay DS. The Mechanical Axis of the First Ray: A Radiographic Assessment in Hallux Abducto Valgus Evaluation. J Foot Ankle Surg, 2016;55(1):28-34.
  • 22. Baumhauer JF, Nowoczenski DA, DiGiovanni BF, Wilding GE. Reliability and validity of the American Orthopaedic Foot and Ankle Society Clinical Rating Scale: a pilot study for the hallux and lesser toes. Foot Ankle Int 2006;27(12):1014-9.
  • 23. Hardy RH, JC Clapham. Observations on hallux valgus; based on a controlled series. J Bone Joint Surg Br 1951;33-B(3):376-91.
  • 24. Coughlin MJ, PS Shurnas. Hallux valgus in men. Part II: First ray mobility after bunionectomy and factors associated with hallux valgus deformity. Foot Ankle Int 2003;24(1):73-8.
  • 25. Karabicak GO, Bek N, Tiftikci U. Short-Term Effects of Kinesiotaping on Pain and Joint Alignment in Conservative Treatment of Hallux Valgus. J Manipulative Physiol Ther 2015;38(8):564-71.
  • 26. Menz HB, Rody E, Thomas E, Croft PR. Impact of hallux valgus severity on general and foot-specific health-related quality of life. Arthritis Care Res (Hoboken), 2011;63(3):396-404.
  • 27. Yamamoto Y, Yamaguchi D, Muramatsıu Y et al. Quality of Life in Patients With Untreated and Symptomatic Hallux Valgus. Foot Ankle Int 2016;37(11):1171-7.
  • 28. Parker J, Nester CJ; Long AF, Barrie J. The problem with measuring patient perceptions of outcome with existing outcome measures in foot and ankle surgery. Foot Ankle Int 2003;24(1):56-60.
  • 29. Baker CL Jr. Lower extremity problems in female athletes. J Med Assoc Ga 1997;86(3):193-6.

Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı ve Fonksiyonel Skorlar Üzerine Etkisi

Year 2018, , 584 - 591, 27.12.2018
https://doi.org/10.17098/amj.501715

Abstract

Amaç: Kliniğimizde Halluks Valgus (HV) deformitesi bulunan hastaların konservatif tedavi yöntemi

olan gece ateli uygulaması ile takiplerinde HV açılarının ve fonksiyonel skorlarındaki değişimin

incelenmesi amaçlanmıştır

Materyal ve Metot: Ocak 2017 – Mayıs 2018 tarihleri arasında Ankara Yıldırım Beyazıt Üniversitesi

Yenimahalle Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği’ne başvuran HV

deformitesi tanısı almış hastalar bu retrospektif araştırmanın çalışma grubunu oluşturdu. Çalışma grubu

içinde 227 hasta dosyası geriye dönük olarak tarandı. Hastalardan ayak radyografisinde 25 derece

üzerinde HV açısı olup 6 aylık gece ateli (splint) ile konservatif tedavi edilenlerin (n=76) HV açısı ve

fonksiyonel skorlarındaki değişme kaydedilerek tedavi öncesi ve sonrası karşılaştırmalar yapıldı.

Bulgular: Çalışma grubumuzda (n=76); bayan popülasyonda (n=68) daha sıklıkla görülen HV

deformitesinin başvuru sebepleri arasında ağrının (%53,94), kozmetik bozukluktan (%46,05) ön planda

olduğu ve ayakta çalışılan mesleklerde (n=33 / %75,75) daha sık semptom verdiği izlendi. 6 ay süre ile

gece ateli kullanımı sonrası HV açılarında anlamlı azalama olmadığı (p=0,563) ancak fonksiyonel

skorlamalarda anlamlı düzeyde (ağrı; p=0,022 ve fonksiyon; p=0,031) iyileşme olduğu izlendi.

Sonuç: Orta ve ileri yaş grubunda HV deformitesi bulunan ve HV açılarının yüksek olduğu hasta

grubunda uzun süreli gece atelinin efektif olarak kullanılması HV açısında kısmi azalma ile birlikte

fonksiyonel skorlarda anlamlı derecede düzelme sağlamıştır. Yüksek HV açıları olmasına rağmen cerrahi

tedavi istemeyen hasta grubunda uzun süreli gece ateli uygulaması hayat kalitesinin artmasında yararlı

olabilir.

References

  • 1. Mann RA, Coughlin MJ. Hallux valgus--etiology, anatomy, treatment and surgical considerations. Clin Orthop Relat Res 1981;157:31-41.
  • 2. Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int 2007;28(7):759-77.
  • 3. Spink MJ, Menz HB, Lord SR. Distribution and correlates of plantar hyperkeratotic lesions in older people. J Foot Ankle Res 2009;2:8.
  • 4. Joseph TN, Mroczek KJ. Decision making in the treatment of hallux valgus. Bull NYU Hosp Jt Dis 2007;65(1):19-23.
  • 5. Solan MC, Lemon M, Bendall SP. The surgical anatomy of the dorsomedial cutaneous nerve of the hallux. J Bone Joint Surg Br 2001;83(2):250-2.
  • 6. Brahm SM. Shape of the first metatarsal head in hallux rigidus and hallux valgus. J Am Podiatr Med Assoc 1988;78(6):300-4.
  • 7. Helal B. Surgery for adolescent hallux valgus. Clin Orthop Relat Res 1981;157:50-63.
  • 8. Coughlin MJ. Hallux valgus. J Bone Joint Surg Am, 1996;78(6):932-66.
  • 9. Pique-Vidal C, MT Sole, J Antich, Hallux valgus inheritance: pedigree research in 350 patients with bunion deformity. J Foot Ankle Surg 2007;46(3):149-54.
  • 10. Kato T, Watanabe S. The etiology of hallux valgus in Japan. Clin Orthop Relat Res, 1981;157:78-81.
  • 11. Shereff MJ, Pathophysiology, anatomy, and biomechanics of hallux valgus. Orthopedics 1990;13(9):939-45.
  • 12. Crawford VL. Conservative podiatric medicine and disability in elderly people. J Am Podiatr Med Assoc 1995;85(5):255-9.
  • 13. Benvenuti F, Ferrucci L, Guralnik JM, Gangemi S, Baroni A. Foot pain and disability in older persons: an epidemiologic survey. J Am Geriatr Soc 1995;43(5):479-84.
  • 14. Dunn JE, Link CL, Felson DT, Crincoli MG, Keysor JJ, McKinlay JB. Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol, 2004;159(5):491-8.
  • 15. Cho NH, Kim S, Kwon DJ, Kim HA. The prevalence of hallux valgus and its association with foot pain and function in a rural Korean community. J Bone Joint Surg Br 2009;91(4):494-8.
  • 16. Nork SE, Coughlin RR. How to examine a foot and what to do with a bunion. Prim Care 1996;23(2):281-97.
  • 17. Ferrari J, Higgins JP, Williams RL. Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database Syst Rev 2000(2): p. CD000964.
  • 18. Garrow AP, Papageorgiou A, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ. The grading of hallux valgus. The Manchester Scale. J Am Podiatr Med Assoc 2001;91(2):74-8.
  • 19. Srivastava S, Chockalingam N, El Fakhri T. Radiographic angles in hallux valgus: comparison between manual and computer-assisted measurements. J Foot Ankle Surg 2010;49(6):523-8.
  • 20. Srivastava S, Chockalingam N, El Fakhri T. Radiographic measurements of hallux angles: a review of current techniques. Foot (Edinb) 2010;20(1):27-31.
  • 21. LaPorta GA, Nasser EM, Mulhern JL, Malay DS. The Mechanical Axis of the First Ray: A Radiographic Assessment in Hallux Abducto Valgus Evaluation. J Foot Ankle Surg, 2016;55(1):28-34.
  • 22. Baumhauer JF, Nowoczenski DA, DiGiovanni BF, Wilding GE. Reliability and validity of the American Orthopaedic Foot and Ankle Society Clinical Rating Scale: a pilot study for the hallux and lesser toes. Foot Ankle Int 2006;27(12):1014-9.
  • 23. Hardy RH, JC Clapham. Observations on hallux valgus; based on a controlled series. J Bone Joint Surg Br 1951;33-B(3):376-91.
  • 24. Coughlin MJ, PS Shurnas. Hallux valgus in men. Part II: First ray mobility after bunionectomy and factors associated with hallux valgus deformity. Foot Ankle Int 2003;24(1):73-8.
  • 25. Karabicak GO, Bek N, Tiftikci U. Short-Term Effects of Kinesiotaping on Pain and Joint Alignment in Conservative Treatment of Hallux Valgus. J Manipulative Physiol Ther 2015;38(8):564-71.
  • 26. Menz HB, Rody E, Thomas E, Croft PR. Impact of hallux valgus severity on general and foot-specific health-related quality of life. Arthritis Care Res (Hoboken), 2011;63(3):396-404.
  • 27. Yamamoto Y, Yamaguchi D, Muramatsıu Y et al. Quality of Life in Patients With Untreated and Symptomatic Hallux Valgus. Foot Ankle Int 2016;37(11):1171-7.
  • 28. Parker J, Nester CJ; Long AF, Barrie J. The problem with measuring patient perceptions of outcome with existing outcome measures in foot and ankle surgery. Foot Ankle Int 2003;24(1):56-60.
  • 29. Baker CL Jr. Lower extremity problems in female athletes. J Med Assoc Ga 1997;86(3):193-6.
There are 29 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Articles
Authors

Mustafa Akkaya

Publication Date December 27, 2018
Published in Issue Year 2018

Cite

APA Akkaya, M. (2018). Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı ve Fonksiyonel Skorlar Üzerine Etkisi. Ankara Medical Journal, 18(4), 584-591. https://doi.org/10.17098/amj.501715
AMA Akkaya M. Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı ve Fonksiyonel Skorlar Üzerine Etkisi. Ankara Med J. December 2018;18(4):584-591. doi:10.17098/amj.501715
Chicago Akkaya, Mustafa. “Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı Ve Fonksiyonel Skorlar Üzerine Etkisi”. Ankara Medical Journal 18, no. 4 (December 2018): 584-91. https://doi.org/10.17098/amj.501715.
EndNote Akkaya M (December 1, 2018) Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı ve Fonksiyonel Skorlar Üzerine Etkisi. Ankara Medical Journal 18 4 584–591.
IEEE M. Akkaya, “Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı ve Fonksiyonel Skorlar Üzerine Etkisi”, Ankara Med J, vol. 18, no. 4, pp. 584–591, 2018, doi: 10.17098/amj.501715.
ISNAD Akkaya, Mustafa. “Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı Ve Fonksiyonel Skorlar Üzerine Etkisi”. Ankara Medical Journal 18/4 (December 2018), 584-591. https://doi.org/10.17098/amj.501715.
JAMA Akkaya M. Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı ve Fonksiyonel Skorlar Üzerine Etkisi. Ankara Med J. 2018;18:584–591.
MLA Akkaya, Mustafa. “Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı Ve Fonksiyonel Skorlar Üzerine Etkisi”. Ankara Medical Journal, vol. 18, no. 4, 2018, pp. 584-91, doi:10.17098/amj.501715.
Vancouver Akkaya M. Halluks Valgus Deformitesi Bulunan Hastalarda Gece Ateli Kullanımının Halluks Valgus Açısı ve Fonksiyonel Skorlar Üzerine Etkisi. Ankara Med J. 2018;18(4):584-91.