Journal List > J Korean Foot Ankle Soc > v.21(4) > 1043428

Kang, Song, Kim, Oh, and Yoo: The Effect of Second Toe Valgus on Correction Loss of Hallux Valgus Angle in Surgical Treatment



The purpose of this study is to determine the correlation between the correction loss of hallux valgus angle and the severity of valgus angle of the second toe.

Materials and Methods:

We selected 312 cases from 268 surgical patients with hallux valgus deformity receiving distal chevron osteotomy. For a radiological evaluation, we analyzed the changes in the hallux valgus angles, first to second intermetatarsal angles, and valgus angle of the second toe post index operations. All patients were women; the mean age was 46 years. The mean follow-up period was 17 months.


The mean hallux valgus angle was 33.6° preoperatively (range, 25.7°∼44.8°), 13.1° (range, 8.4°∼16.4°) after 4 weeks of postoperative period, and 17.1° (range, 9.4°∼28.5°) at their final follow-up. The mean valgus angle of the second toe was 8.4° preoperatively (range, 2.0°∼25.8°) and 8.3° (range, 1.7°∼24.9°) at the final follow-up. Preoperatively, there was a positive correlation between the valgus angle of the second toe and hallux valgus angle (r=0.747, p=0.001). The correction loss of hallux valgus angle had a significant correlation with the severity of valgus angle of the second toe (r=0.802, p=0.001).


The existence of the second toe valgus deformity may present itself as a cause of correction loss of hallux valgus angle. The preoperative measurement of the second toe valgus angle may be a good predictor of correction loss; therefore, thorough preoperative warning on the possibility of correction loss should be conducted to maximize patient satisfaction after the procedure.


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Figure 1.
The second metatarsal and proximal phalanx were bisected to give the valgus angle of 2nd toe.
Table 1.
Changes in Radiologic Indices
Preoperative 4 wk after operation Final follow-up
Hallux valgus angle (°) 33.6 (25.7∼44.8) 13.1 (8.4∼16.4) 17.1 (9.4∼28.5)
1∼2 intermetatarsal angle (°) 17.1 (15.6∼22.1) 6.6 (4.6∼9.1) 7.1 (5.1∼9.3)
Valgus angle of 2nd toe (°) 8.4 (2.0∼25.8) - 8.3 (1.7∼24.9)

Values are presented as mean (range).

Table 2.
Comparison of Correction Loss of Hallux Valgus Angle according to Valgus Angle of 2nd Toe
Valgus angle of 2nd toe (°) p-value*
<5 5∼15 >15
No. of cases 104 63 47
Mean CLA (°) 1.62 2.87 11.71 0.001

CLA: Correction loss of hallux valgus angle. *By independent t-test.

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