UNIFESP-Escola Paulista de Medicina, São Paulo, Brazil.
Foot Ankle Int. 2013 May;34(5):629-35. doi: 10.1177/1071100713475350. Epub 2013 Feb 5.
The high frequency of hallux valgus deformities in females is well known and has been widely reported in the literature. This finding tends to obscure the importance and the characteristic details of hallux valgus deformities in males. The severity of the deformity, its onset at an earlier age, and its inheritability seem to be more frequent in males, but there are no reports in the literature to substantiate these concepts. The purpose of this study was to analyze these questions in regard to males with hallux valgus.
The records and plain radiographs of 31 males (53 feet) with a diagnosis of hallux valgus that were treated over a 20-year period (1985-2005) were analyzed. During that same period, the senior author (CN) performed 812 procedures for the correction of hallux valgus deformities in women. In order to compare gender-related differences associated with this deformity, 31 women's charts-paired by age and affected side-were randomly selected and both clinical and radiological data were statistically compared.
The onset of the complaints of first ray pain in males was equally distributed by decades, indicating that the deformity begins earlier in this group. Among males, we found 68% of the subjects had a familial history of bunion deformities-58% were maternal and 10% were fraternal. In the control group of females, only 35% of the women reported inheritance of the deformity. No correlation with footwear was found among males. The radiographic measurements were significantly higher in the male group, which included the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), and the tarsal metatarsal angle (TMA). The main gender difference was found to be the DMAA with first metatarsophalangeal (MTP) joint congruence being much more common in males (males = 57%, females = 30%). No correlations were found for metatarsus primus varus or pes planus.
Based on our observations, we conclude that hallux valgus in males is commonly hereditary in nature and is mainly transmitted by the mother, with early onset and higher severity when compared to women. We report a female/male ratio of 15:1. The main intrinsic factor associated with a hallux valgus deformity in males is a high DMAA.
Level III, retrospective comparative series.
众所周知，女性的踇外翻畸形发病率很高，并且在文献中有广泛的报道。这一发现往往掩盖了男性踇外翻畸形的重要性和特征性细节。男性的畸形严重程度、发病年龄更早、遗传性似乎更为常见，但文献中尚无报道证实这些概念。本研究的目的是分析男性踇外翻患者的这些问题。
分析了 20 年间（1985-2005 年）收治的 31 例（53 足）诊断为踇外翻的男性患者的病历和 X 线片。在同一时期，高级作者（CN）对 812 例女性踇外翻畸形进行了矫正手术。为了比较与这种畸形相关的性别差异，随机选择了 31 名女性患者的病历，这些患者的年龄和受累侧与男性相匹配，并对其临床和影像学数据进行了统计学比较。
男性第一跖骨疼痛的发病开始时间在各十年间分布均匀，表明该组患者的畸形发病更早。在男性中，我们发现 68%的患者有家族性拇外翻畸形史-58%为母系遗传，10%为父系遗传。在女性对照组中，只有 35%的女性报告了畸形的遗传。在男性中未发现与鞋类有关的相关性。男性组的 X 线测量值明显较高，包括踇外翻角（HVA）、远侧跖骨关节角（DMAA）和跗跖角（TMA）。主要的性别差异是第一跖趾关节（MTP）关节的 DMAA，男性更为常见（男性=57%，女性=30%）。未发现跖骨内翻或扁平足的相关性。
根据我们的观察，我们得出结论，男性的踇外翻通常是遗传性的，主要由母亲遗传，与女性相比，发病早，严重程度更高。我们报告的男女比例为 15:1。与男性踇外翻畸形相关的主要内在因素是较高的 DMAA。
III 级，回顾性比较研究。
