Forefoot plantar shear stress distribution in hallux valgus patients.

BACKGROUND: Hallux valgus is a common foot disorder often experienced with secondary callosities and metatarsalgia. Many factors including improper shoes might be responsible in the pathophysiology of the problem. Hallux valgus deformity has been shown to alter the biomechanics of the whole foot rather than affecting only the great toe. Due to changes in the biomechanical functioning of the first ray, other regions of the forefoot area have been shown to bear abnormal loads with increased vertical loading on medial, central and lateral forefoot regions. The purpose of this study was to investigate the pattern of forefoot plantar shear loading in hallux valgus patients and compare these results with those of control subjects.

METHODS: A total of 28 subjects were recruited for the study of which 14 were clinically diagnosed with hallux valgus. A custom built platform was used to collect peak pressure and shear data. A repeated measures analysis of variance was used to analyze the recorded data.

FINDINGS: Antero-posterior shear was significantly lower in the deformity group (p<0.05). The lateral forefeet of the patients, however, experienced slightly higher shear loads (p>0.05).

INTERPRETATION: Propulsive shear force generation mechanism under the medial forefoot was impaired in the disorder group. In general, shear loading of the plantar feet shifted laterally. Previously hypothesized higher medio-lateral shear magnitudes under the hallux were not confirmed.