Study of the effectiveness of osteopathic correction of the Ist toe valgus deformity of the I–II degree

Abstract

Introduction. Valgus deformity of the Ist toe (hallux valgus) is a multicomponent deformity of the forefoot, which is the most common reason for visiting orthopedic surgeons. By now, there is idea that the hallux valgus development has a complex polyetiological and polypathogenetic nature. It makes a complex approach to treatment with the inclusion of methods focused on a holistic approach to body′s complex biomechanical systems in demand. One of such well-established and validated approach is osteopathy.The aim of the study is to investigate the effectiveness of osteopathic correction of hallux valgus of the Ist toe of the I–II degree.Materials and methods. The study involved 52 patients with valgus deformity of I toe, aged from 18 to 40 years. Two groups were formed by randomization envelopes method: the main group (26 participants who received osteopathic correction) and the control group (26 participants who received imitation of osteopathic correction). At the beginning and at the end of the study, the osteopathic status and severity of clinical manifestations of hallux valgus of the first finger were assessed (using the AOFAS questionnaire and the clinical-radiological Grulier scale, as well as radiography of the feet with a load in a direct projection).Results. Patients with valgus deformity of the Ist toe are characterized by the presence of global postural disorders, regional biomechanical disorders of the head, neck regions (structural and visceral component), lumbar and pelvic regions (structural and visceral component), as well as dura mater. Local somatic dysfunctions of the musculoskeletal system (tarsal-metatarsal and metatarsal-phalangeal joints, diaphragm, foot bones) and craniosacral system (temporomandibular joint, TMJ, skull sutures) were also revealed. Osteopathic correction is accompanied by a statistically significant (p<0,05) decrease in the frequency of detection of all listed regional disorders (except for the lumbar region, structural component) and most local (except for local TMJ dysfunctions). Global postural disorders are not detected after the correction. The clinical manifestations severity of valgus deformity of the first finger decreases statistically significantly (p<0,05), by such parameters as the interplatarsal angle value (from 12 to 11,4 degrees on average) and the valgus deviation of I finger angle (from 21 to 20,3 angles on average); the AOFAS questionnaire indicators also improve (from 56,4 to 77,5 points on average) and the Grullier scale (from 48,2 to 67,7 points on average) too.Conclusion. The results obtained during the study allow to consider the possibility of recommending the inclusion of osteopathic correction in the complex conservative treatment of hallux valgus of the Ist toe.