Prevalence of Hallux Valgus in Patients With Femoral Neck Fracture and Its Association With Postoperative Functional Outcomes.

Background

Hallux valgus is a frequent forefoot deformity in older adults and has been linked to impaired balance, gait dysfunction, and increased fall risk. However, its prevalence among patients with femoral neck fracture and its association with postoperative functional outcomes remain unclear.

Methods

This single-center retrospective study included 235 patients aged ≥ 65 years with available radiographic data who underwent surgery for femoral neck fracture between 2022 and 2024. Hallux valgus was defined on weight-bearing radiographs as a hallux valgus angle (HVA) ≥ 20°. Functional outcomes were evaluated using the Functional Independence Measure (FIM) at 3 months postoperatively. Multivariable linear regression analysis was performed to determine whether hallux valgus was independently associated with motor FIM scores after adjustment for age, sex, surgical procedure, and cognitive function.

Results

Among the 235 patients with radiographic data, 178 (76%) were women, with a median age of 85 (77-90) years; 86% of patients underwent bipolar hemiarthroplasty. Hallux valgus was present in 55% (130/235), including 20% (47/235) with moderate-to-severe deformity (HVA ≥ 30°). Patients with hallux valgus had significantly lower motor FIM scores at 3 months than those without the deformity (p = 0.044), whereas cognitive and total FIM scores did not differ. In multivariable analysis, hallux valgus (HVA ≥ 20°) was independently associated with lower motor FIM scores (B = -5.92, 95% CI -10.95 to -0.89; p = 0.021).

Conclusions

Hallux valgus is highly prevalent in patients with femoral neck fracture and is independently associated with lower postoperative motor function. Assessment of hallux valgus may provide additional insight into postoperative functional prognosis in this population.

Keywords

femoral neck fracture, functional independence measure, hallux valgus, older adults, postoperative function