Intra-articular fracture of proximal phalanx of great toe accompanied by valgus deformity associated with sports activities.

Abstract

We analyzed clinical and radiologic examination of intra-articular fracture of the proximal phalanx of great toe accompanied by valgus deformity associated with sports activities. Therefore, we assessed valgus deformity of great toe at fracture side and contralateral side by simple radiograph in order to confirm the causal relation of fracture and deformity. A retrospective study was conducted on 23 cases, between January 2000 and August 2014, which showed an intra-articular fracture of proximal phalanx which was diagnosed after visiting our hospital for valgus deformity of great toe as a chief complaint. All patients were involved in sports activities for over 2 years. The site of fracture was the lateral side of the proximal phalanx head in 16 cases and the medial side of the proximal phalanx base in 7 cases. In order to assess the valgus deformity of great toe, hallux valgus angle (HVA) and hallux valgus interphalangeal angle (HVIPA) were measured on the weight-bearing foot radiograph. The average HVA of the fracture group on the lateral side of the proximal phalanx head was 10.5° and HVIPA was 17.8°, while the average HVA of the fracture group on the medial side of the proximal phalanx base was 18.1° and HVIPA was 10.7°. Among the 16 cases with a fracture on the lateral side of the head, 13 cases showed hallux valgus interphalangeus (81.3%), while all 7 cases of fracture on the medial side of the base showed hallux valgus (100%). Hallux valgus was mostly found on the fracture of the medial side of the proximal phalanx base, while hallux valgus interphalangeus was mostly found on the fracture of the lateral side of the proximal phalanx head.