Incidence of hallux valgus deformity among Iranian university students

Document Type : Original article

Authors

1 Associate professor of Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 MSc in Orthotics and Prosthetics, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 BSc in Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Assistant Professor of Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Background and Aim: The dramatically increased incidence of hallux valgus (HV) deformity is more related to the cultural rather than genetic parameters. Due to the lack of reliable information about the rate of this disorder in Iraninan societies, the researchers of the current study aimed to find out the incidence of this disorder in Iranian university students as a sample of Iranian youngsters.
Materials and Methods: This descriptive study was carried out using a self-constructed and the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaires among 290 university students with the mean age of 21±2 years old. The HV angles (HVA) was described as normal for up to 20º, mild for angles between 21º and 25º, moderate for angles between 26º and 40º, and severe for angles higher than 40 º. Then, the HVA of the subjects of this study was compared with the data from other societies.
Results: The results of this study showed a 34.1% involvement of the participants (30% females and 41% males). 58% of the subjects showed a bilateral hallux valgus involvement. No significant differences were found between the males and females in terms of the severity of the deformity and the right or left side involvement (P>0.05). 71% of the involved subjects showed a mild degree and 29% showed a moderate degree of deformity. No severe deformity (above 40º) was found in this study. In terms of the associated deformities, in subjects with mild deformity, 25% showed flat foot and 69% showed bunion disorder; While these were 21% and 82% in subjects with moderate deformity, respectively. In terms of inheritance correlation, while this deformity was shown in only 7% of normal subjects’ first degree relatives (father, mother, brothers or sisters), it increased to 21.1% in mild degree and 46.4% in moderate degree groups.
Conclusion: This study revealed a very high incidence of HV deformity in Iranian university students as a sample of Iranian youngsters, which is much higher than those in some Western societies. This deformity showed to be highly inherent due to the increasing level of this deformity among first degree relatives. Routine use of high heel or round tip shoes showed no influence on the rate of HV deformity. 

Keywords


  1. Jahss M. Disorders of the foot. Philadelphia: PA, WB Saunders Co. 1982. Vol 1: 548-608.
  2. Hardy RH, Thomas S, Barrington R. Hallux Valgus. Current Orthopaedics 2003; 17(4):299-307.
  3. Richardson G. Disorders of the Hallux. Campbell's Operative Orthopedics. 8th Ed. St. Louis: CV Mosby, 1992. p. 2615-2681.           
  4. Trepal MJ. Hallux valgus and metatarsus adductus: the surgical dilemma. IN: O’Kane C, Kilmartin TE. The rotation Scarf and Akin osteotomy for the correction of severe hallux valgus. The Foot 2002; 12(4): 203-212
  5. Coughlin MJ, Thompson FM. The high price of high-fashion footwear. In: The American Academy of Orthopaedic Surgeons, eds. Instructional course lectures.  Instr Course Lect 1995; 44:371-7.
  6. Kato T, Watanabe S. The aetiology of hallux valgus in Japan. Clin Orthop 1981; 157: 78–81.
  7. Lam SF, Hodgson AR. A comparison of foot forms among the non-shoe and shoe-wearing Chinese population. J Bone Joint Surg 1958; 40A:1058-1062.
  8. Kilmartin & Wallace: The aetiology of hallux valgus: a critical review of the literature. The Foot 1993, 3(4):157-167.
  9. Kilmartin TE, Barrington RL, Wallace WA. Metatarsus primus varus a statistical study. J Bone Joint Surg Br 1991; 73(6):937-40.
  10. Thomas S, Barrington R. Hallux valgus. Current Orthopaedics 2003; 17(4):299-307.
  11. Piggott, H: The natural history of hallux valgus in adolescence and early adult life. J Bone Joint Surg 1960; 42B: 749-760.
  12. Bonney G, McNab I. Hallux valgus and hallux rigidus: critical survey of operative results. J Bone Joint Surg Br 1 952; 34-B:366-85.
  13. Harris MCR. Beeson B. Is there a link between juvenile hallux abducto valgus and generalized hypermobility? A review of the literature 1998; 8(3): 125–128.
  14. Nakhaee Z, A. Rahimi, M. Abaee, A. Rezasoltani, K. Khademi Kalantari. The relationship between the height of the medial longitudinal arch (MLA) and the ankle and knee injuries in professional runners. Foot Edinb 2008; 18(2):84-90.
  15. Sami S, Reffa D. Hallux valgus and preffered shoe types among young healthy Saudi Abariban females. Ann Saudi Med 2000; 20(3-4):319-21.
  16. Gudas CJ, Marcinko DE. The complex deformity known as hallux abductor valgus. In: Marcinko DE, ed.Comprehensive textbook of hallux valgus reconstruction. St Louis: Mosby: p 1–17.
  17. Gould N, Schneider W, Ashikaga T. Epidemiological survey of foot problems in the continental United States: 1978-1979. Foot Ankle 1980;1(1):8-10.
  18. Frank CJ, Satake N, Robinson D E, Gentchos C E. Medascape References. [Homepage on the Internet]. 2009 [cited 2012 Dec 24]. Available from: http://emedicine.medscape.com/article/1232902-overview.
Volume 1, Issue 2 - Serial Number 2
July and August 2012
Pages 45-53
  • Receive Date: 16 June 2011
  • Revise Date: 05 November 2011
  • Accept Date: 28 February 2012
  • First Publish Date: 21 June 2012