Hallux Valgus İnterfalangeus: Literatür Derlemesi ve İki Bilateral Pediatrik Vakanın Sunumu

Yıl 2026, Cilt: 8 Sayı: 1, 182 - 192, 28.02.2026

Nurettin Manti , Merve Bozer , Kenan Şen , Mehmet İsmail Kapıcıoğlu

https://doi.org/10.52827/hititmedj.1696556

https://izlik.org/JA67PF28MS

Öz

Öz
Halluks valgus interfalangeus (HVI), ayak başparmağının distal falanksında interfalangeal eklem seviyesinde meydana gelen valgus deformitesidir. Genellikle erişkinlerde ve özellikle halluks valgus (HV) ile birlikte görülse de, pediatrik popülasyonda varlığı literatürde nadiren tanımlanmıştır. HVI’nin etiyopatogenezi çok faktörlüdür; öne sürülen nedenler arasında konjenital anomaliler, büyüme plağında duraklama (fizyel arrest), osteokondral travma ve anormal tendon yerleşimleri yer almaktadır. Halluks interfalangeal açısının (HVIA) 10°’nin üzerinde olması genellikle patolojik olarak kabul edilir.
Amaç
Bu çalışmanın amacı, biri literatürde bildirilen ilk bilateral adölesan HVI vakası olmak üzere, idiopatik HVI tanısı alan iki pediatrik olguyu sunmak ve literatürü kapsamlı bir şekilde inceleyerek HVI için tanısal kriterleri tanımlamak, radyolojik ölçüm standartlarını belirlemek ve tüm yaş grupları için mevcut tedavi yaklaşımlarını değerlendirmektir.
Yöntemler
Ocak 2025'e kadar olan dönemde PubMed/MEDLINE veri tabanı kullanılarak sistematik bir literatür taraması gerçekleştirildi. Toplam 59 makale tespit edilmiş olup, sıkı uygunluk kriterlerine göre 37’si çalışmaya dahil edildi. Çalışmalar dört tematik gruba ayrıldı: radyolojik değerlendirme, erişkin klinik çalışmaları, pediatrik vakalar ve bireysel olgu sunumları.
Bulgular
Güncel literatür, HVI tanısında HIA (halluks interfalangeal açısı), PPAA (proksimal falanks aksiyel açısı) ve PDPAA (distal falanks aksiyel açısı) gibi standartlaştırılmış açılar kullanılarak yapılan doğru radyografik değerlendirmenin önemini vurgulamaktadır. HVI bazı asemptomatik hastalarda dahi gözlemlenebilmektedir. Başlangıçta konservatif tedavi tercih edilmekle birlikte, semptomatik veya progresif vakalarda en sık uygulanan cerrahi yöntem Akin osteotomisi olmaktadır. Pediatrik hastalarda büyüme plağının korunması esastır; seçilmiş vakalarda epifiziyodez veya fizyeli yönlendirilmiş düzeltici işlemler düşünülebilir.

Anahtar Kelimeler

Akin Osteotomisi , Halluks Interfalangeal Açısı , Halluks Valgus Interfalangeus , Pediatrik Ayak Deformitesi

Hallux Valgus Interphalangeus: Review of the Literature and A Report of Two Bilateral Pediatric Cases

https://izlik.org/JA67PF28MS

Öz

Background
Hallux valgus interphalangeus is a valgus deformity of the distal phalanx at the interphalangeal joint of the great toe. Although frequently observed in adults, particularly in association with hallux valgus, its presence in the pediatric population remains rarely described in the literature. The etiopathogenesis of HVI is multifactorial, with proposed causes including congenital anomalies, physeal arrest, osteochondral trauma, and abnormal tendon insertions. A hallux interphalangeal angle (HVIA) exceeding 10° is typically considered pathological.
Purpose
This study aims to present two pediatric cases of idiopathic hallux valgus interphalangeus - one of which represents the first reported case of bilateral adolescent hallux valgus interphalangeus - and to provide a comprehensive review of the literature to define diagnostic criteria, outline radiological measurement standards, and evaluate current treatment modalities for hallux valgus interphalangeus across all age groups.
Methods
A systematic literature review was conducted using the PubMed/MEDLINE database up to January 2025, identifying 59 articles, of which 37 were included based on strict eligibility criteria. Studies were categorized into four thematic groups: radiologic assessment, adult clinical studies, pediatric cases, and individual case reports.
Results
Recent literature underscores the importance of accurate radiographic assessment using standardized angles, such as the hallux interphalangeal angle, proximal phalangeal articular angle, and proximal distal phalangeal articular angle, with hallux valgus interphalangeus being observed even in asymptomatic patients. Conservative treatment remains the initial approach; however, surgical correction - most commonly via Akin osteotomy - is indicated in symptomatic or progressive cases. In pediatric patients, growth plate preservation is essential, and procedures such as epiphysiodesis or physeal-guided correction may be considered in selected cases.

Anahtar Kelimeler

Hallux Valgus Interphalangeus , Pediatric Foot Deformity , Akin Osteotomy , Hallux Interphalangeal Angle

Kaynakça

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