Posição do sesamoide lateral em relação ao segundo metatarso em pés com e sem hálux valgo

Abstract

ObjectivesDetermine if the sesamoids migrate laterally in the feet with hallux valgus or if they only appear to move, maintaining their relationship with the other structures of the forefoot. MethodsRadiographs of the anteroposterior incidence of 80 patients (94 feet) were evaluated in the years 2015 and 2016, with the feet under load. Of these, 48 had a valgus hallux angle greater than 15 (hallux valgus group) and 46 had a hallux valgus angle less than 15 (control group). The distances of the head of the first metatarsal and of the lateral sesamoid to the axis of the second metatarsus were measured. Subsequently, the coefficients of these distances were measured by the length of the second metatarsal in order to adjust for the different foot sizes. ResultsBoth the absolute measure and the relative measure of the head from the first metatarsal to the second metatarsal were significantly different in the two groups, having a positive correlation with the valgus hallux and intermetatarsal angles. However, neither the absolute nor the relative distance of the lateral sesamoid to the second metatarsal were different in the two groups, as they did not correlate with the valgus hallux and intermetatarsal angles. ConclusionsDespite the medial deviation of the first metatarsus in hallux valgus, the sesamoid maintains its relation with the second metatarsal in the transverse plane. This apparent lateral displacement may lead to misinterpretation of these radiographs. This fact is of paramount importance in the pre‐, intra‐, and postoperative period of patients with hallux valgus.