Proximal Opening Wedge Osteotomy With Distal Chevron Osteotomy of the First Metatarsal for the Treatment of Moderate to Severe Hallux Valgus
| Autor: | Philipp Hofer-Picout, Matthias Braito, Gerhard Kaufmann, Dietmar Dammerer |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Moderate to severe
Adult Male medicine.medical_treatment Osteotomy 03 medical and health sciences 0302 clinical medicine Postoperative Complications Medicine Chevron (geology) Humans Orthopedics and Sports Medicine Prospective Studies Hallux Valgus Double osteotomy Aged Orthodontics Aged 80 and over 030222 orthopedics biology business.industry First metatarsal Foot Bones 030229 sport sciences Middle Aged biology.organism_classification Bunionectomy Opening wedge osteotomy Radiography Valgus Treatment Outcome Surgery Female business Bone Plates |
| Zdroj: | Footankle international. 40(1) |
| ISSN: | 1944-7876 |
| Popis: | Background:The aim of this study was to assess radiographic and clinical outcomes after double osteotomy with proximal opening wedge first metatarsal osteotomy and first metatarsal distal chevron osteotomy in the treatment of moderate to severe hallux valgus.Methods:33 patients (4 male, 29 female; 36 feet; average age 60.7 years) were included in the study. Radiographic and clinical outcome in terms of intermetatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and the American Orthopaedic Foot & Ankle Society metatarsophalangeal-interphalangeal hallux score (AOFAS MTP-IP hallux score) were investigated at 6 weeks, 6 months, and after an average of 28 (range, 7-123) months postoperatively.Results:Preoperative IMA, HVA, and DMMA showed statistically significant improvement ( P ≤ .05) from 19.1 ± 3.8 (8.9-27.3) degrees, 45.4 ± 8.7 (25.9-60.9) degrees, and 20.8 ± 8.9 (4.5-38.0) degrees to 6.0 ± 3.3 (0.4-12.2) degrees, 9.1 ± 8.9 (–6.7 to 39.0) degrees, and 6.4 ± 5.6 (–6.8 to 21.0) degrees at last follow-up, respectively. Postoperative AOFAS MTP-IP hallux score averaged 88.1 points. Overall, 10 complications were observed: hallux varus (3 feet), hallux valgus recurrence (3 feet), nonunion (1 foot), loss of fixation (1 foot), and wound infection (2 feet).Conclusion:Proximal opening wedge first metatarsal osteotomy with distal chevron osteotomy provided powerful correction of each component of moderate to severe hallux valgus but had a substantial rate of complications in terms of over- and undercorrection, nonunion, loss of fixation, and wound infection.Level of Evidence:Level IV, case series. |
| Databáze: | OpenAIRE |
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