Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 23940
ASSESSMENT OF LATERAL SESAMOID IN HALLUX VALGUS AND ITS
CORRELATION WITH THE CONVENTIONAL ASSESSMENT
Yuvraj AGRAWAL, Aravind DESAI, Jaysheel MEHTA
Pennine Acute Hospitals NHS Trust, Manchester (UNITED KINGDOM)
Introduction: Conventional radiological assessment of hallux valgus involves
measuring intermetatarsal angle (IMA1-2), hallux valgus angle (HVA), congruity of
metatarsophalangeal joint and overall clinical assessment of the forefoot. However,
in current practice, these angles are seldom measured. We observed a consistent
pattern of deviation of head of first metatarsal in relation to the lateral sesamoid (LS).
The position of LS in relation to head of first metatarsal has never been studied
before. We aim to study this pattern to quantify the severity of the deformity and
establish its correlation with the conventional technique. Methods: 122 radiographs of
67 consecutive patients who underwent a weight bearing radiographs of their feet
were studied. IMA1-2 and HVA were graded as AAOS guidelines. Statistical analysis
was performed to identify correlation of displacement with conventional
measurements. Results: A definite pattern in displacement of LS was noted.
Statistical analysis showed a high correlation between LS position and IMA1-2 with
correlation coefficient Rho of 0.74 and a good statistical correlation between LS
position and HVA with a Spearman’s rank correlation coefficient Rho of 0.56.
Discussion: LS lies laterally and any progressive deformity makes it more accessible
to assessment in contrast to medial sesamoid. We report a consistent pattern and
classified this position as normal, mild, moderate and severe. As it does not involve
any measurements, we believe, this is quick technique of assessment of HV
deformity and should help to base our operative decisions. A statistically significant
correlation with the conventional techniques was also established.
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