title: Multisegmental foot and ankle motion analysis after hallux valgus surgery.
abstract: BACKGROUND
  Gait changes in patients with hallux valgus, including altered kinematic and temporal-spatial parameters, have been documented in the literature. Although operative treatment can yield favorable clinical and radiographic results, restoration of normal gait in this population remains unclear. Segmental kinematic changes within the foot and ankle during ambulation after operative correction of hallux valgus have not been reported. The aim of this study was to analyze changes in multisegmental foot and ankle kinematics in patients who underwent operative correction of hallux valgus.
  
  
  METHODS
  A 15-camera Vicon Motion Analysis System was used to evaluate 24 feet in 19 patients with hallux valgus preoperatively and postoperatively. The Milwaukee Foot Model was used to characterize segmental kinematics and temporal-spatial parameters (TSPs). Preoperative and postoperative kinematics and TSPs were compared using paired nonparametric methods; comparisons with normative data were performed using unpaired nonparametric methods. Outcomes were evaluated using the SF-36 assessment tool.
  
  
  RESULTS
  Preoperatively, patients with hallux valgus showed significantly altered temporal-spatial and kinematic parameters. Postoperatively, kinematic analysis demonstrated restoration of hallux position to normal. Hallux valgus angles and intermetatarsal angles were significantly improved, and outcomes showed a significant increase in performance of physical activities. Temporal-spatial parameters and kinematics in the more proximal segments were not significantly changed postoperatively.
  
  
  CONCLUSIONS
  Postoperative results demonstrated significant improvement in foot geometry and hallux kinematics in the coronal and transverse planes. However, the analysis did not identify restoration of proximal kinematics.
  
  
  CONCLUSIONS
  Further investigation is necessary to explore possible causes/clinical relevance and appropriate treatment interventions for the persistently altered kinematics.
authors.affiliation: Marquette University, Orthopaedic and Rehabilitation Engineering Center, Academic Support Facility, Milwaukee, WI 53233, USA. kcanseco@mcw.edu
authors.forename: Karl
authors.initials: K
authors.lastname: Canseco
authors.forename: Jason
authors.initials: J
authors.lastname: Long
authors.forename: Thomas
authors.initials: T
authors.lastname: Smedberg
authors.forename: Sergey
authors.initials: S
authors.lastname: Tarima
authors.forename: Richard M
authors.initials: RM
authors.lastname: Marks
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Harris
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology*; D006215:Hallux Valgus / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D018709:Statistics, Nonparametric; D016896:Treatment Outcome