Comparative Analysis of Structural Differences in Progressive Collapsing Foot Deformity With and Without Hallux Valgus

Chien-Shun Wang; Erik Jesús Huánuco Casas; Grayson M Talaski; Antoine S Acker; Mark E Easley; Cesar de Cesar Netto

doi:10.1177/10711007241298672

Comparative Analysis of Structural Differences in Progressive Collapsing Foot Deformity With and Without Hallux Valgus

Foot Ankle Int. 2024 Nov 26:10711007241298672. doi: 10.1177/10711007241298672. Online ahead of print.

Authors

Chien-Shun Wang^{1

2}, Erik Jesús Huánuco Casas^{3

4}, Grayson M Talaski⁵, Antoine S Acker^{3

6}, Mark E Easley³, Cesar de Cesar Netto³

Affiliations

¹ Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.
² Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
³ Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.
⁴ Department of Traumatology and Orthopedics, Delgado Clinic, Lima-Perú.
⁵ Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
⁶ Centre of Foot and Ankle Surgery, Clinique La Colline, Geneva, Switzerland.

PMID: 39589087
DOI: 10.1177/10711007241298672

Abstract

Background: Progressive collapsing foot deformity (PCFD) and hallux valgus (HV) are complex 3-dimensional deformities of the foot. This study aimed to investigate structural and alignment differences between PCFD with and without HV using weightbearing computed tomography.

Methods: Patients with PCFD aged 18 years or older who underwent weightbearing computed tomography were consecutively enrolled. Standard 2-dimensional PCFD and HV parameters were assessed semiautomatically. Foot and ankle offset, forefoot arch angle, and pronation of the medial column bones in the coronal plane, with the ground as a reference, were manually measured. Additionally, the angles from the inferior aspect of subtalar posterior facet of the talus to the ground (subtalar horizontal angle), from the inferior (posterior facet) to superior facets of the talus (infratalar-supratalar angle), and from the inferior (posterior facet) of the talus to the superior facet of the calcaneus (infratalar-supracalcaneal angle) were examined. HV deformity was defined by an HV angle of ≥15 degrees.

Results: Among 72 feet (58 patients) studied, 33 displayed HV, whereas 39 did not. In the coronal plane, the PCFD with HV group showed a higher infratalar-supratalar angle and greater pronation at the first tarsometatarsal joint, first metatarsal bone, and head. The PCFD with HV group also exhibited greater naviculocuneiform joint supination. Generalized estimating equation logistic regression analysis revealed significant associations of HV deformity with the intrinsic rotation of the first metatarsal bone (P < .001), infratalar-supratalar angle (P = .004), and rotation of the first tarsometatarsal joint (P < .001).

Conclusion: This study confirmed significant structural and alignment differences between PCFD with and without HV. Notably, the infratalar-supratalar angle, rotation of the first tarsometatarsal joint, and intrinsic rotation of the first metatarsal bone were associated with HV deformity.

Level of evidence: Level III, retrospective comparative study.

Keywords: hallux valgus; overpronated deformity; progressive collapsing foot deformity; weightbearing computed tomography.