Do radiological parameters affect quality of life in patients with untreated and symptomatic hallux valgus?

Abstract

Objectives: The aim of this study is to investigate the effect of the disease on quality of life (QoL) in patients with not operated symptomatic hallux valgus (HV) and the relationship between the degree of deformity classified by radiological parameters and QoL.

Methods: In this prospective study, 100 patients (33 males, 67 females; mean age 49.25 ± 15.20 years; range 18 to 75 years) who were admitted to our institution and diagnosed with HV between March 2019 and February 2020 were included. Hallux valgus angle (HVA) and intermetatarsal angle (IMA) were used to assess the degree of deformity. The Visual Analog Scale (VAS), the Foot Function Index (FFI), and the 36-Item Short-Form Health Survey (SF-36) instruments were used to evaluate patients.

Results: The severity of HVA associated with SF-36 scores for physical health, social functioning, bodily pain, general health, and mental health (p < 0.05). Differences were found between the degrees of IMA for social functioning, bodily pain, and general health scores in SF-36 (p < 0.05). A significant statistical correlation was observed between pain scores in VAS and severity of HVA and IMA. Higher scores in VAS and FFI were recorded from the participants with high degrees of HVA (p < 0.05). However, no relationship was found between the radiographic severity of the IMA and the FFI.

Conclusions: In this study, it was shown that the QoL decreased as the degree of deformity increased in HV patients. In addition, it was concluded that HVA is a more basic radiological predictor than IMA in the evaluation of HV patients.

Keywords

• hallux valgus
• radiological parameters
• quality of life

References

1. 1. Mortka K, Lisinski P. Hallux valgus-a case for a physiotherapist or only for a surgeon? Literature review. J Phys Ther Sci 2015;27:3303-7.
2. 2. Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res 2010;3:21.
3. 3. Nguyen US, Hillstrom HJ, Li W, Dufour AB, Kiel DP, Procter-Gray E, et al. Factors associated with hallux valgus in a population-based study of older women and men: the MOBILIZE Boston Study. Osteoarthritis Cartilage 2010;18:41-46.
4. 4. Bascarević ZL, Vukasinović ZS, Bascarević VD, Stevanović VB, Spasovski DV, Janicić RR. Hallux valgus. Acta Chir Iugosl 2011;58:107-11.
5. 5. D’Arcangelo P, Landorf K, Munteanu S, Zammit G, Menz H. Radiographic correlates of hallux valgus severity in older people. J Foot Ankle Res 2010;3:20.
6. 6. Menz HB, Roddy 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;63:396-404.
7. 7. Menz HB, Lord SR. Foot pain impairs balance and functional ability in community dwelling older people. J Am Podiatr Med Assoc 2001;91:222-9.
8. 8. Rao S, Song J, Kraszewski A, Backus S, Ellis SJ, Deland JT, et al. The effect of foot structure on first metatarsophalangeal joint flexibility and hallucal loading. Gait Posture 2011;34:131-137.

9. 9. Gilheany MF, Landorf KB, Robinson P. Hallux valgus and hallux rigidus: a comparison of impact on health-related quality of life in patients presenting to foot surgeons in Australia. J Foot Ankle Res 2008;1:14-20.
10. 10. Menz HB, Lord SR. The contribution of foot problems to mobility impairment and falls in community-dwelling older people. J Am Geriatr Soc 2001;49:1651-6.
11. 11. 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;91:494-8.
12. 12. McKean RM, Bergin PF, Watson G, Mehta SK, Tarquinio TA. Radiographic evaluation of intermetatarsal angle correction following first MTP joint arthrodesis for severe hallux valgus. Foot Ankle Int 2016;37:1183-6.
13. 13. Bennett PJ, Patterson C, Dunne MP. Health-related quality of life following podiatric surgery. J Am Podiatr Med Assoc 2001;91:164-73.
14. 14. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain. Arthritis Care Res (Hoboken) 2011;63:240-52.
15. 15. Yalıman A, Şen EI, Eskiyurt N, Budiman-Mak E. Turkish translation and adaptation of foot function index in patients with plantar fasciitis. Turk J Phys Med Rehab 2014;60: 212-22.
16. 16. Nix SE, Vicenzino BT, Smith MD. Foot pain and functional limitation in healthy adults with hallux valgus: a cross-sectional study. BMC Musculoskelet Disord 2012;16:197.
17. 17. Steinberg N, Finestone A, Noff M, Zeev A, Dar G. Relationship between lower extremity alignment and hallux valgus in women. Foot Ankle Int 2013;34:824-31.
18. 18. Martínez-Nova A, Sánchez-Rodríguez R, Pérez-Soriano P, Llana-Belloch S, Leal-Muro A, Pedrera-Zamorano JD. Plantar pressures determinants in mild hallux valgus. Gait Posture 2010;32:425-7.
19. 19. Coughlin MJ, Shurnas PS. Hallux rigidus: demographics, etiology, and radiographic assessment. Foot Ankle Int 2003;24:731-43.
20. 20. Roan LY, Tanaka Y, Taniguchi A, Tomiwa K, Kumai T, Cheng YM. Why do lesser toes deviate laterally in hallux valgus? A radiographic study. Foot Ankle Int 2015;36:664-72.
21. 21. Chadchavalpanichaya N, Prakotmongkol V, Polhan N, Rayothee P, Seng-Iad S. Effectiveness of the custom-mold room temperature vulcanizing silicone toe separator on hallux valgus: A prospective, randomized single-blinded controlled trial. Prosthet Orthot Int 2018;42:163-70.
22. 22. Radovic PA. Nonsurgical treatment for hallux abducto valgus with botulinum toxin type A. J Am Podiatr Med Assoc 2020;110:Article_6.
23. 23. Heineman N, Liu G, Pacicco T, Dessouky R, Wukich DK, Chhabra A. Clinical and imaging assessment and treatment of hallux valgus. Acta Radiologica 2020;61:56-66.
24. 24. Lazarides SP, Hildreth A, Prassanna V, Talkhani I. Association amongst angular deformities in hallux valgus and impact of the deformity in health-related quality of life. Foot Ankle Surg 2005;11:193-6.
25. 25. Shakked R, McDonald E, Sutton R, Lynch MK, Nicholson K, Raikin SM. Influence of depressive symptoms on hallux valgus surgical outcomes. Foot Ankle Int 2018;39:795-800.
26. 26. Cody EA, Do HT, Koltsov JCB, Mancuso CA, Ellis SJ. Influence of diagnosis and other factors on patients’ expectations of foot and ankle surgery. Foot Ankle Int 2018;39:641-8.
27. 27. López DL, Callejo González L, Losa Iglesias ME, Canosa JL, Sanz DR, Lobo CC, et al. Quality of life impact related to foot health in a sample of older people with hallux valgus. Aging Dis 2016;7:45-52.
28. 28. Palomo-López P, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Rodríguez-Sanz D, Calvo-Lobo C, López-López D. Impact of hallux valgus related of quality of life in women. Int Wound J 2017;14:782-5.
29. 29. González-Martín C, Alonso-Tajes F, Pérez-García S, Seoane-Pillado MT, Pértega-Díaz S, Couceiro-Sánchez E, et al. Hallux valgus in a random population in Spain and its impact on quality of life and functionality. Rheumatol Int 2017;37:1899-1907.
30. 30. Schrier JC, Palmen LN, Verheyen CC, Jansen J, Koëter S. Patient-reported outcome measures in hallux valgus surgery. A review of literature. Foot Ankle Surg 2015;21:11-5.