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Published on: February 17, 2018
Classification of hallux valgus deformity-is there a standard?
Fabian T Spindler1, Sarah Ettinger2,
1Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Ziemssenstraße 5, 80336, Munich, Germany.
Insights
Classifications for hallux valgus (HV) deformity lack standardization. This review found significant heterogeneity in cut-off values for grading severity, indicating a need for a unified system.
Area of Science:
- Orthopedics
- Podiatry
- Surgical Assessment
Background:
- Hallux valgus (HV) deformity severity impacts surgical correction decisions.
- Classifications typically categorize HV into mild, moderate, or severe.
- Standardized criteria are crucial for consistent clinical assessment and treatment planning.
Purpose of the Study:
- To investigate the specific cut-off criteria used for classifying hallux valgus deformity severity.
- To identify commonly referenced classification systems in the literature.
- To evaluate the consistency and standardization of current hallux valgus grading methods.
Main Methods:
- A living systematic review methodology was employed.
- Searches were conducted across four major databases for the past decade.
- Data extraction focused on cut-off values for mild/moderate/severe HV and referenced classification systems, with dual reviewer assessment.
Main Results:
- Forty-six studies were included in the analysis.
- Significant heterogeneity was observed in the intermetatarsal angle (IMA) and hallux valgus angle (HVA) cut-off values used for grading.
- The Coughlin and Mann's and Robinson classifications were the most frequently cited systems.
Conclusions:
- Current hallux valgus classification systems exhibit considerable heterogeneity.
- A universally accepted, uniform classification system for hallux valgus deformity is currently undefined.
- The scientific community should collaborate to establish a standardized classification system.
Introduction:
Hallux valgus deformity severity is one determent for the surgical procedure for hallux valgus (HV) correction. HV deformities are usually classified into mild/moderate/severe. The aim was to investigate the cut-off criteria used to classify HV deformity.
Materials And Methods:
The study was based on a previous living systematic review. Four common databases were searched for the last decade. All review-steps were conducted by two reviewers. Data assessed were the individual cut-off values used to classify HV deformity into mild/moderate/severe, and the referenced classification systems.
Results:
46 studies were included. 21/18 studies grade deformity based on the intermetatarsal angle (IMA)/ hallux valgus angle (HVA) with great heterogeneity throughout the different cut-off values. The most referenced classification systems were the Coughlin and Mann's and the Robinson classification.
Conclusions:
The currently used classification systems are heterogenic, and no standard could be defined. The community should define a uniform classification system.
Level Of Evidence:
Level I, systematic review of randomized controlled trials and prospective comparative studies.
