Orthoses Effect on Radiographic Measurements of Hallux Abducto Valgus: A Systematic Review

Area of Science:

• Orthopedics
• Podiatry
• Biomechanics

Background:

• Hallux abducto valgus (HAV), or bunions, are common foot deformities with multiple causes.
• Orthotic devices are frequently used for conservative management of HAV.
• The efficacy of orthotics in modifying radiographic HAV measurements is debated.

Purpose of the Study:

• To systematically review the impact of orthotic interventions on radiographic parameters of HAV.
• To evaluate if orthotics can alter key measurements like the hallux abductus angle (HAA), hallux valgus angle (HVA), and intermetatarsal angle (IMA).

Main Methods:

• A systematic literature search was performed across five major databases (PubMed, Cochrane Library, CINAHL, Medline, EMBASE) up to March 2021.
• Included studies provided pre- and post-treatment radiographic HAV measurements (HAA, HVA, IMA) following orthotic use.
• Five studies met the inclusion criteria from an initial 523 references.

Main Results:

• Insufficient high-quality evidence supports orthotics in slowing HAV radiographic progression.
• Results were mixed, with only one study (using toe spacers) showing significant changes.
• Three studies found no significant impact of orthotics on HAA, HVA, or IMA.

Conclusions:

• Current evidence does not conclusively support orthotics for altering radiographic HAV progression.
• Orthotics may offer symptomatic relief, but their role in deformity correction is unclear.
• Further research is needed to definitively establish the effect of orthotics on radiographic HAV measures.