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Updated: Jan 21, 2026
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An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
Published on: February 17, 2018
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Hallux Pronation in Hallux Valgus: Experimental and Radiographic Study
Mercedes Gómez Galván1, J A Constantino2, María José Bernáldez1
1Surgeon, Infanta Cristina University Hospital, Badajoz, Spain.
Summary
Big toe pronation, often seen in hallux valgus (HV), can now be quantified using a new radiographic formula. This finding is crucial for accurately assessing hallux valgus severity.
Area of Science:
- Orthopedics
- Biomechanics
- Radiology
Background:
- Toe pronation is a common but challenging-to-measure sign in hallux valgus (HV).
- Accurate assessment of toe pronation is vital for understanding HV severity.
Purpose of the Study:
- To evaluate the relationship between big toe pronation and radiological/clinical findings in hallux valgus.
- To determine if toe pronation influences the severity of hallux valgus.
Main Methods:
- Developed a radiographic calibration system for proximal phalanges (0°-60° pronation).
- Used linear regression to predict proximal phalanx pronation from radiographs.
- Clinically assessed 132 HV patients and 30 controls, measuring various foot angles including nail-floor angle.
Main Results:
- A reliable equation was derived to predict proximal phalanx pronation from radiographic measurements (p < .001, r=0.98).
- Significant correlations were found between hallux valgus severity and proximal phalanx pronation, nail-floor angle, and first metatarsal pronation (p < .0001, r=0.64).
- High intra- and interobserver reliability was confirmed for the measurements (ICC = 0.89/0.82).
Conclusions:
- Proximal phalanx pronation and nail-floor angle are significant indicators for classifying hallux valgus severity.
- The developed mathematical formula enables prediction of proximal phalanx pronation on radiographs.
- These findings offer a more objective method for assessing hallux valgus.
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