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Sensory dysfunction in the great toe in hallux valgus.
1Department of Orthopaedic and Trauma Surgery, Warwick District General Hospital, Lakin Road, Warwick CV34 5BW, UK.
The Journal of Bone and Joint Surgery. British Volume
|February 10, 2004
Summary
Many patients with hallux valgus have undiagnosed sensory loss in their great toe. Objective sensory testing before surgery is recommended to identify nerve deficits and prevent potential post-operative complications.
Area of Science:
- Podiatric Surgery
- Neurology
- Biomedical Engineering
Background:
- Hallux valgus surgery can lead to dorsomedial cutaneous nerve injury.
- Pre-operative pressure neuropathy in hallux valgus is under-researched.
Purpose of the Study:
- To determine the incidence of great toe sensory deficit before hallux valgus surgery.
- To correlate sensory loss with the degree of joint angulation.
Main Methods:
- Semmes-Weinstein monofilaments were used to test sensation in 61 hallux valgus-affected great toes.
- High inter-observer reliability (ICC=0.84) was achieved with the testing method.
Main Results:
- 21% of patients reported sensory symptoms.
- An additional 44% exhibited measurable sensory reduction (≥1 monofilament grade).
- No correlation was found between sensory loss and joint angulation degree.
Conclusions:
- Symptomatic hallux valgus patients may have unrecognized sensory deficits.
- Subjective sensation is an unreliable indicator of sensory function.
- Objective sensory testing should be routine pre-operative assessment for hallux valgus.