In hallux valgus surgery, it is essential to accurately assess the position of the sesamoids both pre- and postoperatively. Weight-bearing foot anteroposterior, tangential sesamoid, and semi-weight-bearing computed tomography axial views are radiographic methods used to assess the medial sesamoid position. This study aimed to measure the medial sesamoid position and evaluate the correlation between these three radiographic methods.
This retrospective study comprised 59 feet from 49 patients who underwent hallux valgus surgery. The mean age of patients was 54.6 (range, 22–70) years. We took preoperative and postoperative measurements using the weight-bearing anteroposterior, tangential sesamoid, and semi-weight-bearing computed tomography axial views to assess the medial sesamoid position.
The mean grades of the medial sesamoid position preoperatively and 6 months postoperatively were 2.5 and 0.8, 1.6 and 0.4, and 1.3 and 0.3 points based on the anteroposterior, tangential sesamoid, and computed tomography axial views, respectively (P < 0.001). Preoperatively, there was a strong positive correlation between the computed tomography axial and tangential sesamoid views (P < 0.001, r = 0.645) and anteroposterior and computed tomography axial views (P < 0.001, r = 0.468). In contrast, the tangential sesamoid and anteroposterior views showed a weak positive correlation (P = 0.03, r = 0.283). Six months postoperatively, there was a positive correlation between the computed tomography axial and tangential sesamoid views (P < 0.001, r = 0.473), anteroposterior and computed tomography axial views (P < 0.001, r = 0.470), and tangential sesamoid and anteroposterior views (P < 0.001, r = 0.480).
We observed that the anteroposterior view exhibited a higher degree of medial sesamoid position displacement than the computed tomography axial and tangential sesamoid views. For the preoperative evaluation of the medial sesamoid position, the correlation between the computed tomography axial and tangential sesamoid views was stronger than that between the tangential sesamoid and anteroposterior views. However, all three views showed strong correlations postoperatively.
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- A new measure of tibial sesamoid position in hallux valgus in relation to the coronal rotation of the first metatarsal in CT scans.Foot Ankle Int. 2015 Aug; 36 (PMID: 25813535): 944-952
- Hallux valgus--etiology, anatomy, treatment and surgical considerations.Clin Orthop Relat Res. 1981 Jun; (PMID: 7249460): 31-41
- Range of motion of the first metatarsophalangeal joint after chevron procedure reinforced by a modified capsuloperiosteal flap.Foot Ankle Int. 2008 Sep; 29 (PMID: 18778668): 903-909
- Observations on hallux valgus; based on a controlled series.J Bone Joint Surg Br. 1951 Aug; 33-B (PMID: 14861244): 376-391
- Relationship between displacement and degenerative changes of the sesamoids in hallux valgus.Foot Ankle Int. 2016 Dec; 37 (PMID: 27530982): 1303-1309
- The extensor hallucis longus and the flexor hallucis longus tendons in hallux abducto valgus.J Am Podiatry Assoc. 1978 Jul; 68 (PMID: 670631): 467-472
- Anatomic determinants of first metatarsophalangeal flexion moments in hallux valgus.Clin Orthop Relat Res. 1997 Jun; 339 (PMID: 9186228): 261-269
- Importance of postoperative sesamoid reduction on the outcomes of proximal chevron osteotomy for moderate to severe hallux valgus deformity.Foot Ankle Surg. 2019 Aug; 25 (PMID: 30321971): 434-440
- Correction of hallux valgus using lateral soft-tissue release and proximal Chevron osteotomy through a medial incision.J Bone Joint Surg Am. 2007 Oct; 89 (PMID: 17908874): 82-89
- Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus.J Bone Joint Surg Am. 2009 Jul; 91 (PMID: 19571086): 1637-1645
- Recurrence of hallux valgus can Be predicted from immediate postoperative non-weight-bearing radiographs.J Bone Joint Surg Am. 2017 Jul 19; 99 (PMID: 28719558): 1190-1197
- Crescentic proximal metatarsal osteotomy for moderate to severe hallux valgus: a mean 12.2 year follow-up study.Foot Ankle Int. 2001 Oct; 22 (PMID: 11642533): 817-822
- Proximal supination osteotomy of the first metatarsal for hallux valgus.Foot Ankle Int. 2015 Jun; 36 (PMID: 25710936): 696-704https://doi.org/10.1177/1071100715572188
- Effect of metatarsophalangeal joint position on the reliability of the tangential sesamoid view in determining sesamoid position.Foot Ankle Int. 2005 Mar; 26 (PMID: 15766429): 247-250
- New radiographic analysis of sesamoid rotation in hallux valgus: comparison with conventional evaluation methods.Foot Ankle Int. 2002 Sep; 23 (PMID: 12356178): 811-817
- Hallux valgus assessment: report of research committee of American Orthopaedic Foot and Ankle Society.Foot Ankle. 1984 Sep-Oct; 5 (PMID: 6389278): 92-103
- Assessing sesamoid subluxation: how good is the AP radiograph?.Foot Ankle Int. 1998 Aug; 19 (PMID: 9728703): 547-554
- Sesamoid position in healthy volunteers without deformity: a computed tomography study.J Foot Ankle Surg. 2016 May-Jun; 55 (PMID: 26875766): 461-464
- Hallux valgus angle as a predictor of recurrence following proximal metatarsal osteotomy.J Orthop Sci. 2011 Nov; 16 (PMID: 21818604): 760-764
- Biomechanics of the first ray. Part II: metatarsus primus varus as a cause of hypermobility. A three-dimensional kinematic analysis in a cadaver model.J Foot Ankle Surg. 2000 Mar-Apr; 39 (PMID: 10789097): 68-77
- Axial rotation of the first metatarsal head in a normal population and hallux valgus patients.Orthop Traumatol Surg Res. 2012 Oct; 98 (PMID: 22939107): 677-683
- Hallux valgus and cartilage degeneration in the first metatarsophalangeal joint.J Bone Joint Surg Br. 2004 Jul; 86 (PMID: 15274261): 669-673
- Predicting articular erosion in hallux valgus: clinical, radiographic, and intraoperative analysis.J Foot Ankle Surg. 2005 Jan-Feb; 44 (PMID: 15704078): 13-21https://doi.org/10.1053/j.jfas.2004.11.012
- Mann's surgery of the foot and ankle.ninth ed. Saunders, 2014
- Sesamoid position in hallux valgus in relation to the coronal rotation of the first metatarsal.Foot Ankle Clin. 2018 Jun; 23 (PMID: 29729796): 219-230
Published online: February 24, 2023
Accepted: February 3, 2023
Received in revised form: January 20, 2023
Received: October 4, 2022
Publication stageIn Press Corrected Proof
© 2023 Published by Elsevier B.V. on behalf of The Japanese Orthopaedic Association.