ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1682172
This article is part of the Research TopicWeight-Bearing CT in Orthopedic Surgery: A Historical Perspective and Future PathwaysView all articles
Association between Clinical Outcomes and Postoperative First Metatarsal Rotational Alignment Assessed by Weightbearing CT Scan in Hallux Valgus
Provisionally accepted
Suwimol Prusmetikul1
Jakrapong Orapin1
Satetha Vasaruchapong2
Tulyapruek Tawonsawatruk1
Suphaneewan Jaovisidha3
Rawee Manatrakul3Phatthawit Tangkittithaworn3Sukij Laohajaroensombat1*- 1Department of Orthopedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Thailand
- 2Chakri Naruebodin Medical Institute, Bang Phli District, Thailand
- 3Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Background: The significance of rotational deformity in operative treatment of hallux valgus is growing, yet its impact on clinical outcomes remains inadequately explored. This study aims to investigate associations between residual rotational deformity and clinical outcomes following hallux valgus corrections. Methods: This retrospective study analysed 47 postoperative feet, using WBCT to measure first metatarsal rotation with α angle. AOFAS Hallux MTP-IP, VAS-FA, and FAOS scores were assessed with the parameter. Results: Patients with residual first metatarsal pronation demonstrated significantly inferior function (84.14 ± 18.50; P-value = 0.04), other complaint subscales (78.78 ± 19.17; P-value = 0.03), and overall score of VAS-FA (82.93 ± 17.99; P-value = 0.04). Lower alignment subscale in AOFAS Hallux MTP-IP (12.26 ± 3.49; P-value = 0.04) was observed, while other scales showed no significant differences between groups. Conclusion: Residual first metatarsal pronation is associated with inferior clinical outcomes in overall score, function, and other complaints subscales of VAS-FA, and alignment subscale of AOFAS Hallux MTP-IP, emphasising the importance of correcting rotational deformity for optimal results. Nonetheless, given the retrospective design with only postoperative assessments, causal inferences regarding the role of residual pronation cannot be established and should be interpreted cautiously.
Keywords: Hallux Valgus, first metatarsal pronation, weightbearing CT scan, clinical outcome, postoperative
Received: 08 Aug 2025; Accepted: 21 Oct 2025.
Copyright: © 2025 Prusmetikul, Orapin, Vasaruchapong, Tawonsawatruk, Jaovisidha, Manatrakul, Tangkittithaworn and Laohajaroensombat. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sukij Laohajaroensombat, lasukij_01@yahoo.com
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