Article

Operative treatment of people with hallux valgus can yield favorable
clinical and radiographic results. However, plantar pressure analysis has
demonstrated that physiologic gait patterns are not restored after hallux valgus
surgery. The purpose of this study was to illustrate the changes of
plantar pressure distribution during the stance phase of gait in patients who
underwent hallux valgus surgery and received a multimodal rehabilitation program.
DESIGN: This was a prospective descriptive study.
METHODS: Thirty patients who
underwent Austin (n=20) and scarf (n=10) osteotomy for correction of mild to
moderate hallux valgus deformity were included in this study. Four weeks
postoperatively they received a multimodal rehabilitation program once per week
for 4 to 6 weeks. Plantar pressure analysis was performed preoperatively and 4
weeks, 8 weeks, and 6 months postoperatively. In addition, range of motion of the
first metatarsophalangeal joint was measured, and the American Orthopaedic Foot
and Ankle Society (AOFAS) forefoot questionnaire was administered preoperatively
and at 6 months after surgery. RESULTS: The mean AOFAS score significantly
increased from 60.7 points (SD=11.9) preoperatively to 94.5 points (SD=4.5) 6
months after surgery. First metatarsophalangeal joint range of motion increased
at 6 months postoperatively, with a significant increase in isolated
dorsiflexion. In the first metatarsal head region, maximum force increased from
117.8 N to 126.4 N and the force-time integral increased from 37.9 N.s to 55.6
N.s between the preoperative and 6-month assessments. In the great toe region,
maximum force increased from 66.1 N to 87.2 N and the force-time integral
increased from 18.7 N.s to 24.2 N.s between the preoperative and 6-month
assessments. LIMITATIONS:
A limitation of the study was the absence of a control
group due to the descriptive nature of the study. CONCLUSIONS: The results
suggest that postoperative physical therapy and gait training may lead to
improved function and weight bearing of the first ray after hallux valgus surgery.

Langue : ANGLAIS