Authors (including presenting author) :
Lau CP (1), Man SW(2), Tai HYD(2), Law YCS(1), Chung KWD(1)
Affiliation :
(1)Prosthetics and Orthotics department, Queen Elizabeth Hospital, Hong Kong, (2) Department of Orthopaedics and Traumatology Queen Elizabeth Hospital, Hong Kong
Introduction :
Hallux valgus is a common foot deformity which is defined as a degenerative joint problem causing a lateral deviation of the first toe and medial deviation of the first metatarsal bone. (Bock P et al, 2004) Patients having hallux valgus often suffer from pain and have limited mobility and stability. There are various methods including conservative and operative as reflected by different literatures to tackle the outcomes of hallux valgus. (Nikolaus Wülker et al, 2012) For example the relatively foot pain, appearances, difficulties in shoe wear and prevention of having another toes problems. Foot orthotic management was shown to be effective in the reduction of foot pain, enhancement of postural stability and reduction of fall rate. (Hawke F et al, 2008) However, hand-crafted fabrication techniques are known may be taken much longer due to logistics, costly and difficult to reproduce. (Lunsford C et al, 2016) (A-footprint) Also, treatment effect was limited by insufficient orthotic treatment options on which to select effective conservative treatment for patients having hallux valgus.
Objectives :
The objectives of the project are to determine process requirement based on the clinical needs for 3D scanning and 3D printing approach in orthotic management for hallux valgus. To evaluate the potential clinical enhancement of orthotic treatment effectiveness for HV patients through 3D printing technology.
Methodology :
The study included 84 patients with 168 feet complete and fulfil the requirement of data collection. 42 patients (37female, 5male) were randomly assigned to each group between intervention group (3D printing) and control group (traditional method).
The primary outcome of the study is the changes of forefoot pain (VAS). The secondary outcomes are including the (i) AOFAS forefoot score (Chinese), (ii) Complicance of and tolerance with orthoses, (iii) Hours per day of orthoses used and (iv) the lead time for the fabrication of orthoses on each approach.
Result & Outcome :
The outcome assessment was performed at baseline, 1st follow up (average 67.4days), and 2nd follow up (average 152.5days). The change of VAS score of forefoot pain was observed in both group, with no significant difference were determined within and between groups (p>0.05).
For the AOFAS forefoot score, there were a significant difference observed on pain, activity limitation and support requirement, MTP joint motion and overall score within intervention group (p< 0.05); and pain, callus related hallux and MTP-IP, and overall score were observed within control groups (p< 0.05). For the between groups comparison, the footwear requirement of control group was significantly lesser than intervention group at 2nd follow up (p< 0.05). However, the alignment of intervention group had a significantly better improvement than control group at 2nd follow up (p< 0.05). For the time consuming of fabricating orthoses at intervention group (38.6 mins) was almost half time shorter than control group (79 mins).
