1
|
Mohan R, Dhotare SV, Morgan SS. Hallux varus: A literature review. Foot (Edinb) 2021; 49:101863. [PMID: 34763225 DOI: 10.1016/j.foot.2021.101863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/12/2021] [Accepted: 09/19/2021] [Indexed: 02/04/2023]
Abstract
Hallux varus is a rare foot deformity due to iatrogenic, post-traumatic, idiopathic, inflammatory, spontaneous, or congenital pathologies. Acquired hallux varus, in particular, iatrogenic type, is the commonest. The primary pathology is the abnormal musculotendinous forces secondary to soft tissue or bony imbalance exerting varus deforming force. Understanding the anatomy of the hallux stabilisers and the pathophysiology of hallux varus is vital in its management. It would be helpful to understand the potential surgical pitfalls leading to iatrogenic hallux varus. This literature review summarises all the published facts about hallux varus, focussing on anatomy, pathophysiology, clinical and radiological assessment, and management.
Collapse
Affiliation(s)
- Rahul Mohan
- Trauma and Orthopaedics, North-West [Mersey] Deanery, Health Education England, United Kingdom.
| | | | | |
Collapse
|
2
|
Lutter C, Schöffl V, Hotfiel T, Simon M, Maffulli N. Compartment Syndrome of the Foot: An Evidence-Based Review. J Foot Ankle Surg 2019; 58:632-640. [PMID: 31256897 DOI: 10.1053/j.jfas.2018.12.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Indexed: 02/03/2023]
Abstract
Compartment syndrome of the foot (CSF) is a surgical emergency, with high risk of morbidity and poor outcome, including persistent neurologic deficits or amputation. Uncertainty remains regarding surgical approaches, pressure monitoring values, and the extent of surgical treatment. This review provides a summary of the current knowledge and reports evidence-based diagnostic and therapeutic management options for CSF. Articles describing CSF were identified from MEDLINE, PubMed, and Cochrane databases up until February 2018. Experimental and original articles, systematic and nonsystematic reviews, case reports, and book chapters, independent of their level of evidence, were included. Crush injuries are the leading cause of CSF, but CSF can present after fractures of the tarsal or metatarsal bones and dislocations of the Lisfranc or Chopart joints. CSF is often associated with persistent neurologic deficits, claw toes, amputations, and skin healing problems. Diagnosis is made after accurate clinical evaluation combined with intracompartmental pressure monitoring. A threshold value of <20 mmHg difference between the diastolic blood pressure and the intracompartmental pressure is considered diagnostic. Management consists of surgery, whereby 2 dorsal incisions are combined with a medioplantar incision to the calcaneal compartment. The calcaneal compartment can serve as an "indicator compartment," as the highest-pressure values can regularly be measured within this compartment. Appropriately powered studies of CSF are necessary to further evaluate and compare diagnostic and therapeutic options.
Collapse
Affiliation(s)
- Christoph Lutter
- Orthopedic Surgeon, Department of Orthopedics, University Medical Center, Rostock, Germany; Orthopedic Surgeon, Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Germany
| | - Volker Schöffl
- Professor of Trauma and Orthopaedic Surgery, Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Germany; Professor of Trauma and Orthopaedic Surgery, Department of Trauma and Orthopedic Surgery, Friedrich Alexander University Erlangen-Nuremberg, Germany
| | - Thilo Hotfiel
- Orthopedic Surgeon, Department of Orthopedic Surgery, Friedrich Alexander University Erlangen-Nuremberg, Germany; Orthopedic Surgeon, Department of Orthopedic, Trauma and Hand Surgery, Klinikum Osnabrück, Germany
| | - Michael Simon
- Orthopedic Surgeon, Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Germany
| | - Nicola Maffulli
- Professor of Trauma and Orthopaedic Surgery and Consultant Trauma and Orthopaedic Surgeon, Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi, Italy; Professor of Trauma and Orthopaedic Surgery and Consultant Trauma and Orthopaedic Surgeon, Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, London, UK; Professor of Trauma and Orthopaedic Surgery and Consultant Trauma and Orthopaedic Surgeon, Institute of Science and Technology in Medicine, Keele University School of Medicine, UK.
| |
Collapse
|
3
|
Lui TH, Pan XH, Pan Y. Arthroscopic and Endoscopic Management of Common Complications After Displaced Intra-Articular Calcaneal Fractures. Clin Podiatr Med Surg 2019; 36:279-293. [PMID: 30784537 DOI: 10.1016/j.cpm.2018.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The list of late complications after calcaneal fracture that can be treated through arthroscopic and/or endoscopic approach continues to expand. The late complications of calcaneal fractures can be classified into 3 groups: (1) those causing focal hindfoot or ankle pain, (2) those causing functional deficit, and (3) those present with diffuse and poorly localized pain. Many group 1 and some group 2 complications can be managed arthroscopically and/or endoscopically. There are usually multiple coexisting sources of the pain. Careful evaluation and analysis of a problem and detailed surgical planning with combination of arthroscopic/endoscopic and open procedures are key to success.
Collapse
Affiliation(s)
- Tun-Hing Lui
- Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong, China.
| | - Xiao-Hua Pan
- Guangdong Provincial Engineering Research Center of Wound Repair and Regenerative Medicine, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, Guangdong 518101, China; Guangdong Provincial Academician Workstation of Wound Repair and Regenerative Medicine, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, Guangdong 518101, China; Department of Trauma and Orthopedics, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, Guangdong 518101, China
| | - Yu Pan
- Guangdong Provincial Engineering Research Center of Wound Repair and Regenerative Medicine, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, Guangdong 518101, China; Guangdong Provincial Academician Workstation of Wound Repair and Regenerative Medicine, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, Guangdong 518101, China; Department of Trauma and Orthopedics, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People's Hospital of Shenzhen, Shenzhen, Guangdong 518101, China
| |
Collapse
|
4
|
Matsumoto T, Shah R, Dave M, Shah N, Parekh SG. Hallux Varus: An Underreported Presentation of Rheumatoid Arthritis. Foot Ankle Spec 2016; 9:169-73. [PMID: 25805438 DOI: 10.1177/1938640015578518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED The prevalence of hallux varus deformity in rheumatoid arthritis (RA) has been reported to be extremely rare. However, in South Asian Countries, where open-toed shoes are habitual footwear for the majority of people, we have found that hallux varus is a common deformity in patients with RA. This rate of occurrence is much more common than that in published hallux deformities in RA and reinforces the impact of footwear on the development of hallux deformities. In this report, we present 3 illustrative cases of hallux varus developed in patients with RA and review the etiology of hallux varus deformity. LEVELS OF EVIDENCE Therapeutic, Level IV: Case Study.
Collapse
Affiliation(s)
- Takumi Matsumoto
- North Carolina Orthopaedic Clinic, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina (TM, SGP)Sunshine Global Hospitals, Vadodara, Gujarat, India (RS, MD, NS)Duke Fuqua School of Business, Durham, North Carolina (SGP)
| | - Rajiv Shah
- North Carolina Orthopaedic Clinic, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina (TM, SGP)Sunshine Global Hospitals, Vadodara, Gujarat, India (RS, MD, NS)Duke Fuqua School of Business, Durham, North Carolina (SGP)
| | - Malhar Dave
- North Carolina Orthopaedic Clinic, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina (TM, SGP)Sunshine Global Hospitals, Vadodara, Gujarat, India (RS, MD, NS)Duke Fuqua School of Business, Durham, North Carolina (SGP)
| | - Nikesh Shah
- North Carolina Orthopaedic Clinic, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina (TM, SGP)Sunshine Global Hospitals, Vadodara, Gujarat, India (RS, MD, NS)Duke Fuqua School of Business, Durham, North Carolina (SGP)
| | - Selene G Parekh
- North Carolina Orthopaedic Clinic, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina (TM, SGP)Sunshine Global Hospitals, Vadodara, Gujarat, India (RS, MD, NS)Duke Fuqua School of Business, Durham, North Carolina (SGP)
| |
Collapse
|
5
|
Rosenthal R, Tenenbaum S, Thein R, Steinberg EL, Luger E, Chechik O. Sequelae of underdiagnosed foot compartment syndrome after calcaneal fractures. J Foot Ankle Surg 2013; 52:158-61. [PMID: 23321291 DOI: 10.1053/j.jfas.2012.11.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Indexed: 02/03/2023]
Abstract
The calcaneus is the most frequently fractured tarsal bone. Compartment syndrome (CS) complicates fractures and other injuries and is most commonly described in association with the lower leg. The long-term sequelae of CS of the foot can include toe clawing, permanent loss of function, persistent pain, muscle atrophy, contracture, painful warts, weakness, and sensory disturbances. The incidence and clinical significance of untreated CS after calcaneal fractures were questioned. All compliant patients treated by us for a calcaneus fracture underwent a physical examination and medical interview: 47 (49 fractures) were included in the final cohort (36 males, 11 females, mean age 49 ± 14.5 years, mean follow-up 23 ± 16 months). Missed CS sequelae were diagnosed by the presence of claw toes and plantar sensory deficits. The functional outcome and pain at rest and during activity were scored. Five patients (10%) had missed CS, and their functional score was significantly lower than for those without CS (52 ± 21.5 versus 77.4 ± 22 for no CS, p < .05). All missed CS cases were diagnosed in patients with a Sanders type 3 or 4 fracture. Intra-articular fracture was a significant factor associated with developing CS sequelae (p = .045). Untreated CS can cause muscle and nerve injury and contribute to a poor functional outcome. Because CS is more likely to develop after highly comminuted intra-articular fractures, these patients warrant close monitoring for CS development. Early detection and treatment might result in fewer late disabling sequelae of this injury.
Collapse
Affiliation(s)
- Ron Rosenthal
- Graduate School of Medicine, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | | | | | | | | | | |
Collapse
|