Classification of Hallucal Sesamoid Bone Correlated with Hallux Valgus Severity.

The hallucal sesamoid bones (HSBs), having an important role in reducing load per unit area on the first metatarsal head, can be injured commonly which also affected the first metatarsophalangeal joint and the surrounding structure. Meanwhile, differences among each HSB type may be a major factor affecting the occurrence and development of HV. So far, many researchers had learned that there are three different conditions in hallucal sesamoid bone affecting the choice of clinical surgery corresponding to different solutions in clinic. Thus, it is necessary to study the anatomical morphological characteristics of the HSB which can be helpful in clinical diagnosis and treatment, especially hallux valgus (HV). 150 X-ray and three-dimensional (3D) computed tomographic (CT) images consist of 72 left and 78 right metatarsals were applied in this anatomic study between two variables and showed by a simple scatter plot. The first metatarsophalangeal joint is divided into four different types: type I (no HSB, 1.3%), type II (with one HSB, 0.07%), type IIIa (with two HSBs when THB is bigger, 28%), type IIIb (with two HSBs when FHB is bigger, 65.3%), and type IV (with three HSBs, 4.7%). There was no statistical difference between the left and right sides, except HVA, Meary, and pitch (P<0.05); all a, b, c, d, and i have statistical difference between male and female (P<0.05). Meanwhile, HVA and IMA and HVA and type group have a significant correlation. In summary, HVA and IMA and HVA and classification of HSBs have significant correlations. The classification and location of HSBs can be an important basis to choose operation methods and postoperation evaluation.