The position of the hallucal sesamoid needs to be included in an evaluation of hallux valgus. In order to quantify the rotational of position of the hallucal sesamoids from weightbearing tangential radiograph, a new tangential positioning device was established. A lead marker line was placed on the most depression aspect of this device, and fitt to the metatarsal head resion. This marker line showed the horizontal plane, and the sesamoid rotation angle (SRA) was measured. The SRA consisted of the angle between tangential line of the most inferior aspect of mediallateral sesamoids and marker line. Hallux valgus angle (HVA) was measured from anteroposterior radiograph. Measurements were made of 20 feet in 10 patients with hallux valgus and 20 feet in 10 normal subjects. A comparison between the two groups showed a significant difference with respect to the SRA. There was a high correlation between SRA and HVA (r=0.876). This device can result in reliable radiographs, and the rotational position of the sesamoids can be assessed quantitatively. We concluded that the SRA is reliable and useful for assessing the rotational position of sesamoids in hallux valgus.
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