Abstract
Background: Hallux valgus (HV) deformity is a common, potentially debilitating deformity. And evidence with high-quality for the conservative treatments of HV deformity is still required.; AIMS: To compare the effects of different conservative treatments for hallux valgus deformity by using the method of network meta-analysis.; Study Design: A systematic review and network meta-analysis of randomized controlled trials identified by searching PubMed, EMBASE, MEDLINE, OVID, and CINAHL. The included studies should have the characteristics that: (1) participants with hallux valgus deformity of any age (2) conservative treatments (3) Reported the hallux valgus (HVA), the intermetatarsal angle (IMA), the score of the Visual Analog Scale, and the score of Foot Function Index.; Results: 11 studies were included in this review. The agreement between reviewers reached a kappa value of 0.75. The results of the network meta-analysis showed that a combination of exercise and toe separator, night splints, and dry needling are most likely to be the best choice for reducing the hallux valgus angle (HVA) and intermetatarsal angle, and toe separators (with or without exercise), dry needling, and manipulation (with or without ice treatment) have advantages in improving the subjective feeling of patients.; Conclusions: Multi-disciplinary conservative treatments have a great potential for hallux valgus deformity. More research with high-quality is needed to give a comprehensive and reasonable scheme of a holistic and long-term treatment protocol.
Highlights
Hallux valgus (HV) deformity, whose definition is a lateral deviation on the first metatarsal joint of the great toe, is a common, potentially debilitating deformity [1]
This systematic review made mixed and indirect comparisons of conservative treatments for hallux valgus deformity, using the morphological indicators, which were the hallux valgus angle (HVA) and intermetatarsal angle (IMA), and the patient-reported outcome measures (PROM), which were the score of Visual Analog Scale (VAS) and the sore of
Hundreds of studies have been published assessing many conservative treatments for HV deformity, at present, there is no enough evidence with high quality about the choice of conservative treatments for HV deformity, and there are only a few randomized trials with a small sample size comparing the difference in the effects of a specific conservative treatment protocol and no-treatment protocol or placebo treatment protocol
Summary
Hallux valgus (HV) deformity (bunion), whose definition is a lateral deviation on the first metatarsal joint of the great toe (hallux), is a common, potentially debilitating deformity [1]. The increased pressure under the head of the first metatarsal caused by increased subtalar pronation or a congenital plantar-flexed first ray would make the metatarsal move medial-dorsally This movement increases the hallux abductus and intermetatarsal angles and places the metatarsal more medial relative to its proximal phalanx. Evidence with high-quality for the conservative treatments of HV deformity is still required.; AIMS: To compare the effects of different conservative treatments for hallux valgus deformity by using the method of network meta-analysis.; Study Design: A systematic review and network metaanalysis of randomized controlled trials identified by searching PubMed, EMBASE, MEDLINE, OVID, and CINAHL. More research with high-quality is needed to give a comprehensive and reasonable scheme of a holistic and long-term treatment protocol
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