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E1701. Preoperative and Postoperative Imaging of a Variety of Hallux Valgus Correction Surgeries: Surgical Correlation and Key Measurements
Authors
  1. Beiyi Shen; Department of Radiology, Stony Brook Medicine
  2. Musa Mufti; Department of Radiology, Stony Brook Medicine
  3. Daichi Hayashi; Department of Radiology, Stony Brook Medicine
  4. Elaine Gould; Department of Radiology, Stony Brook Medicine
  5. Mrugesh Patel; Department of Radiology, Stony Brook Medicine
  6. Isael Perez; Department of Radiology, Stony Brook Medicine
  7. Bernard Martin; Department of Surgery, Stony Brook Medicine
Background
Hallux valgus (HV), also known as bunion, is one of the most common foot deformities. The prevalence of HV in the general population is approximately between 23.0% to 35.7% [1]. There are about 150,000 bunion surgeries performed in the United States each year [2]. The etiology of HV is complex, which could be due to extrinsic factors, anatomic variants, or kinetic changes [1]. A variety of surgical procedures to correct HV have been developed [1]. Imaging, most notably radiographs, plays an important role in assessing the severity of HV, which in turn helps surgeons to select appropriate type of procedure for each patient. Imaging also plays a crucial role in determining the efficacy of surgical correction and possible complications postoperatively [3]. The aim of this exhibit is to illustrate radiographic measurements used for assessment of HV and demonstrate common HV corrective surgeries and their preoperative and postoperative images. Relevant intra-operative images are also included for surgical-radiological correlation.

Educational Goals / Teaching Points
1. To review epidemiological data, clinical features and possible etiologies of hallux valgus. 2. To familiarize radiologists with radiographic measurements in assessing hallux valgus for preoperative planning and procedure selection. 3. To illustrate different hallux valgus corrective procedures and radiographic postoperative assessment.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
1. Overview of Hallux valgus: prevalence, clinical presentation and etiologies. 2. Pictorial review of radiographic measurements of hallux valgus used assessing severity of HV and effects of corrective surgeries. Three primary measurements are the 1st intermetatarsal angle, hallux abductus angle, and metatarsal-sesamoid position. These measurements are done on weight-bearing radiographs taken in the angle and base of gait [4]. 3. Pictorial review of different preoperative and postoperative images of a variety of hallux valgus surgical procedures, including Austin (Chevron) osteotomy, Akin osteotomy, Lapidus procedure, first metatarsophalangeal joint arthrodesis, Keller bunionectomy, and total arthroplasty and implant insertion at the first metatarsophalangeal joint.

Conclusion
HV is a common foot deformity radiologists encounter in interpreting foot radiographs. Many different surgical procedures can be performed to correct HV depending on the severity and etiology. It is important for radiologists to be familiar with radiographic measurements for assessing the severity of HV to help clinicians choose appropriate procedures for patients and assessment effects of surgical procedures on the correction of HV. It is also important for radiologists to know a variety of types of common HV corrective surgeries and be able to recognize hardware, postoperative changes and possible postoperative complications.