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Dynamic-passive correction of hallux valgus and associated static foot deformities

Dygut Jacek, Strąk Joanna, Detyna Jerzy, Piwowar Monika

Acta of Bioengineering and Biomechanics

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2023

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Vol. 25, no. 1

65--77

EN

The aim of this paper was the application of a new dynamic-passive method of treatment in correction of hallux valgus and coexisting static deformities of the foot (transverse-plane and plano-valgus foot). Methods: The study involved 50 patients; 26 with full big toe correction after the passive correction grip (group I) and 24 with big toe correction requiring additional passive abduction (group II). The patients regularly performed exercises using the designed device according to the planned schedule. The progress of the correction was assessed by a medical examination and additional tests. Results: The cross-sectional area [cm2 ] of the abductor hallucis muscle in three-time points among I and II groups of patients with the hallux valgus was measured based on MRI images. The STIR examination showed, among others, the abductor hallucis muscle edema after exercises with the DPc device were carried out. It evidences that exercises with the new device activate the muscle. Alignment of the big toes of both feet in groups I and II were obtained with a statistically significant result ( p < 0.05). The percentage progression of correction for HV and I/II IM was calculated. Conclusions: Based on the new correction approach the alignment of the big toe phalanges and the remaining toes was obtained. The passive setup of the tendons with their distal inserts at the level of the big toe phalanges to the correct path of their course with the withdrawal of articular subluxations was obtained. Simultaneously, the big toe's passive correction was dynamically consolidated through a specially selected set of exercises.

2

Correction of foot deformities with hallux valgus by transversal arch restoration

Dygut Jacek, Piwowar Piotr, Detyna Jerzy, Popiela Tadeusz, Kogut Wojciech, Boron Wiktor, Dudek Piotr, Piwowar Monika

Biocybernetics and Biomedical Engineering

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2020

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Vol. 40, no. 4

1556--1567

EN

The paper presents the effects of the application of a new technical solution along with medical procedures. This approach aims to correct the collapsed transverse arch of the foot and thus restore the physiological course of the anatomical structures. In this way, the alignment of the toes is achieved, thus also eliminating valgus of the big toe. In the article are presented results for 19 patients with stage I and 22 patients with stage II of the foot deformities. Patients applied the orthosis at 57 h daily per one year. Physical examination and X-ray scans were used to assess correction progress. Angles between individual bones of the foot were compared. Correction of the transverse arch of the foot reduces the remain toes deformities of the foot (II–V). The HV angle in the group of patients with the degree I deformity before and after the therapy was 18.38 (3.18) and 15.28 (2.68), respectively, and for patients with degree II deformity it was 19.28 (2.98) and 16.3. (3.28). The correction deficit was reduced in stage I from 22% to 1.33% and in stage II from 28% to 8.6% (p < .05). The proposed approach to treating feet with the developed device, ie Forefoot arch-type orthosis: (1) restores spatial arrangement of tendons, bones, and ligaments and prevents the development of foot contractures (2) enables gradual stretching of extra-articular and capsular contractures (3) can reduce forefoot pain and improves the quality of life.

3

Constraints on variation of weight-shifting by foot during walking in adolescents with valgus alignment of hallux

Latour Ewa, Arlet Jarosław, Latour Marek, Dworak Lechosław B., Bohatyrewicz Andrzej

Acta of Bioengineering and Biomechanics

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2020

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Vol. 22, no. 3

95--104

EN

Purpose: Etiology of hallux valgus (HV) remains unclear and effective treatments and prophylaxis for this condition are lacking and conclusions of researches concerning HV are inconsistent. Recognition of the function-structure interrelation in foot at the early stage of valgus alignment of first metatarsophalangeus joint (1stMTPJ) would help explain the etiology of HV. Methods: The frequency of weight-shifting patterns during walking and the body mass index (BMI) were assessed relative to goniometric measurements of the 1stMTPJ angle in adolescents. Weight-shifting patterns were identified with a plantar pressure analysis, performed with the GaitlineMaxline Distance method. Results: As the 1stMTPJ angle widened, the frequency distributions of identified weight-shifting patterns became increasingly lopsided, due to the favoring or disfavoring of one pattern at the expense of the other. The two sexes showed opposite trends in the weight-shifting patterns that were favored/disfavored, relative to participants with a 0º 1stMTPJ angle. The clear predominance of a central-shift pattern, at the expense of a medial-shift, occurred with the largest (20º) 1stMTPJ angle among girls. Additionally, the BMI distributions associated with 1stMTPJ angle characteristics showed opposite trends between the sexes. Conclusions: Valgus alignment of 1stMTPJ among adolescents were associated with limitations in weight-shifting freedom of the foot during walking, that could be involved in maintaining balance. An 1stMTPJ angle of 20º, where distinct limitations were observed, might serve as a criterion of HV pathology.

4

The transverse arch collapse correction as a path to foot toes alignment

Dygut J., Piwowar P., Kogut W., Boroń W., Piwowar M.

Bio-Algorithms and Med-Systems

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2018

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Vol. 14, no. 3

art. no. 20180014

EN

The study presents a fragment of pilot studies showing the reconstruction of the transverse arch of the foot using a specially constructed orthosis for this purpose. It involves the mechanical reinforcement of the effect by an orthosis, which pushes down the I, IV, and V metatarsal bones while elevating or blocking the fall of the near-immobile II and III metatarsal bones according to the “three-force” rule. The correction of the transverse arch of the foot runs simultaneously with the correction of hallux valgus (HV). As a result, the significant correction of HV and associated toe deformities was achieved. In stage I foot deformity, the reduction of HV was reduced from 19.1° before to 15.1° after putting on orthosis (p = 0.024). In stage II, the reduction was from 20.1° (before) to 16.2° (after; p = 0.032). Equally satisfactory results were obtained for the remaining angles of the metatarsal bones. In the future, the method can be suitable for patients undergoing preparation for corrective HV surgery and for maintaining postoperative HV results. It can be used preventively, for example, by women who frequently wear high-heeled shoes and by those who need to remain standing for prolonged periods of time.

5

Metatarsalgia – pomiary nacisku stopy na podłoże

Jurkojć J., Michnik R., Jochymczyk-Woźniak K., Zagórski A., Olenkowicz M.

Aktualne Problemy Biomechaniki

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2014

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z. 8

69--74

PL

W pracy przedstawiono analizę nacisku stopy na podłoże dla 7 zdrowych osób oraz 4 osób z paluchem koślawym. Badania dynamiczne przeprowadzono przy użyciu bieżni firmy Zebris. Na podstawie raportów wygenerowanych przez oprogramowanie dokonano oceny wpływu metatarsalgii na rozkład nacisku stopy na podłoże. Uzyskane wielkości dotyczące chodu, mapy nacisku stopy na podłoże oraz wielkości opisujące trajektorię środka nacisku otrzymane dla osób z paluchem koślawym, porównano z wynikami osób zdrowych.

EN

The aim of our study was to carry out an analysis of the pressure distribution on the ground for 7 healthy persons and 4 patients with hallux valgus. Dynamic tests were performed using a treadmill Zebris. On the basis of obtained reports the assessment of the influence of Hallux Valgus disease on pressure distribution of foot on the ground was carried out. All results were compared with these obtained for healthy people.

6

Wybrane problemy metrologiczne oceny morfologicznej i funkcjonalnej stopy w leczeniu palucha koślawego

Wychowański M., Nowiński K., Borucki B., Wit A., Adamczyk P., Laskowski J.

Pomiary Automatyka Kontrola

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2012

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R. 58, nr 1

48-51

PL

Paluch koślawy jest chorobą często występującą u kobiet. Wykonano RTG obu stóp w projekcji AP, bocznej i na palcach oraz MRI. Opracowano, trójwymiarowy model strukturalny szkieletu stopy. Przeanalizowano błędy wyznaczenia położeń poszczególnych znaczników. Zbadano równowagęu zdrowych osób metodą stabilograficzną. Pomiarów charakterystyk chodu dokonano na ścieżce podoskopowej. Względem młodszych kobiet przeprowadzono normowanie wyników starszych kobiet. Parametry charakteryzujące badane kobiety nie mają rozkładu normalnego. Profil chodu kobiet starszych opisano 19 parametrami. Różnice w chodzie obu badanych grup kobiet przejawiają się głównie w parametrach geometrycznych. Normy symetrii kobiet podano dla 1 kwartyla, mediany i 3 kwartyla.

EN

Hallux valgus is one of the most frequent forefoot disease in women. There was taken RTG of both feet in the AP, lateral and tip toe projection as well as MRI. A three-dimensional structural foot skeleton model was developed. There was analysed the uncertainty of landmark positioning together with the influence on foot geometric features. Balance mechanism was examined in healthy subjects using the HUR stabilographic platform. Gait characteristics were made on the pressure distribution plate produced by ZEBRIS. There were separated two groups of younger women and a group of older women. Normalization of older women was carried out in relation to the younger group. The parameters characterizing the investigated women did not have a normal distribution. The gait profile of older women is based on 19 parameters. Differences in gait performance of both groups of women are mainly manifested in the geometric parameters. The norms of the symmetry index for the women are given as 1 quartile, median and 3 quartile.