Nerve Dysfunction in Hallux Valgus is Correlated with Degree of Deformity - a Retrospective Analysis of a Consecutive Series of Patients

Background: Hallux valgus the most common forefoot deformity stretches the medial cutaneous nerve. There is a paucity of information regarding neuropathy associated with this often-progressive deformation. Methods: The current study involves two groups: 30 patients examined prior to hallux valgus surgery and 30 foot surgery candidates without hallux valgus that were scheduled for a different operation of the hindfoot or ankle. The patients were assessed for quantitative vibration sensation using a Biothesiometer and for light sensation detection using a standardized monofilament. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured on routine standing radiographs. Results: There were no significant differences between the groups regarding demographic data. There were significant differences in vibration thresholds in some examined points, and in light sensation measurement findings. Pearson’s correlation tests showed good statistically significant correlation between the Hallux Valgus angle and both light touch and vibration threshold measurement, with r ranges between 0.6 to 0.7 and P<0.05.A significant correlation was found between the two sensation modalities (vibration and light touch). Clinical neuropathy and the HVA and IMA. Interpretation: It appears that nerve dysfunction is correlated with the degree of deformity in hallux valgus. Such nerve dysfunction is rare in patients undergoing hindfoot surgery (nerve release procedures were excluded).The current study does not resolve the issue of whether the more severe deformity is the reason for the nerve dysfunction due to digital nerve traction or alternatively the nerve dysfunction is the reason for deformity development.