Hallux valgus: The multidimensional perspective.

BACKGROUND

Hallux valgus (HV) is a three-dimensional deformity commonly assessed using the intermetatarsal angle (IMA), hallux valgus angle (HVA), and sesamoid rotation angle (SRA). We aimed to evaluate a multidimensional metric (MDHV) combining these parameters.

METHODS

This retrospective case-control study included 61 symptomatic HV and 60 control feet assessed by weight-bearing CT. IMA, HVA, and SRA were measured, and MDHV was calculated using principal component analysis.

RESULTS

IMA, HVA, and SRA were significantly higher in HV feet (p < 0.001). MDHV achieved the highest diagnostic accuracy (AUC 0.993), compared with HVA (0.984), SRA (0.963), and IMA (0.915).

CONCLUSION

Three-dimensional evaluation of IMA, HVA and SRA using a single integrated biometric improved diagnostic accuracy. MDHV quantifies deformity severity but does not establish surgical indication, which remains clinical.

LEVEL OF EVIDENCE: Case-control study Level III.