Managing Complications of Foot and Ankle Surgery: Hallux Valgus.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosure There is no relationship with a commercial company that has a direct financial interest in subject matter or materials discussed in article or with a company making a competing product. 7. Skeletal Radiol. 2026 Jul;55(7):1487-1511. doi: 10.1007/s00256-026-05188-1. Epub 2026 Mar 30. Guide to lower extremity radiologic measurements: part 3 ankle and foot. Crone AM(1), Omar IM(2), Bronson AM(3), Mutawakkil MY(4), Selley RS(4), Weaver JS(5), Klauser AS(6), Taljanovic MS(7)(8). Author information: (1)Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 714 North Senate Ave., Suite 200, Indianapolis, IN, 46202, USA. (2)Department of Radiology, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair St., Suite 800, Chicago, IL, 60611, USA. i-omar@northwestern.edu. (3)Department of Radiology, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair St., Suite 800, Chicago, IL, 60611, USA. (4)Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair St., Suite 1350, Chicago, IL, 60611, USA. (5)Department of Radiology, University of Texas at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA. (6)Department of Radiology, Innsbruck Medical University, Privatpraxis Bruneckerstr 2E/5. Stock, Innsbruck, Austria. (7)Departments of Radiology and Imaging Sciences and Orthopaedic Surgery, The University of Arizona, College of Medicine, 1501 North Campbell Ave., Tucson, AZ, 85724, USA. (8)Department of Radiology, University of New Mexico, MSC 10 5530, 1 University of New Mexico, Albuquerque, NM, 87131, USA. The ankle and foot rely on a complex, coordinated interaction of numerous small bones and supporting soft tissues to produce efficient locomotion and weight bearing. Subtle osseous malalignments or insufficiency of tendons and ligaments can result in pain, instability and arthropathy. Although gross malalignment can be seen qualitatively, detecting subtle malalignment often requires standardized measurement on imaging studies with prescribed techniques. Moreover, stress imaging techniques, such as weightbearing or angular stress, are more often used in ankle/foot imaging compared with other lower extremity joints, which results in an added layer of complexity when performing measurements. In the ankle/hindfoot, quantitative assessment is most commonly used to detect and/or characterize ankle instability, calcaneal fractures and posterior tibialis tendon dysfunction. Furthermore, quantitative assessments of ankle arthroplasties may help diagnose device failure. In the midfoot, assessment of the tarsometatarsal joints can help detect subtle Lisfranc instability, while in the forefoot, quantitative characterization of hallux valgus is often used to guide surgical management. This review article is the last of a three-part series discussing measurements of the lower extremities and focuses on common measurements used in the foot and ankle, grouped by pathology, with attention to the imaging study of choice for each measurement, as well as the appropriate technique of measurement. © 2026. The Author(s). DOI: 10.1007/s00256-026-05188-1