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The aim of this study is to evaluate operative treatment of hallux valgus deformity at the Department of Orthopedic surgery, Zagreb School of Medicine, and present our protocol for the management of hallux valgus deformity. In the time period from 1981 to 2000 operative procedures for hallux valgus deformity were performed on 1211 feet in 820 patients (788 females and 32 males). Criteria for operative treatment were: increased hallux valgus angle (HVA), increased first intermetatarsal angle (IMTA), first metatarsophalangeal joint arthritis, pain and cosmetic reasons. Radiographic observations as well as clinical and subjective evaluation were made preoperatively and after the surgery. Observations were classified using Helal's modification of Boney and McNab classification. Resection of the proximal end of the proximal phalanx was performed in 250 patients (402 feet) with 55% of excellent results (221 patients over 60 years of age). Distal first metatarsal Austin osteotomy was performed in 312 patients (429 feet) with 49% of excellent results (210 feet, mean patient age 50 years, mean HVA 27 degrees, mean IMTA 15 degrees). Distal first metatarsal Mitchell osteotomy was performed in 230 patients (380 feet) with 40% of excellent results (152 feet, mean patient age 24 years, mean HVA 26 degrees, mean IMTA 15 degrees). Our experience in the operative treatment of hallux valgus deformity suggests that in order to achieve excellent results after surgery, strict criteria for each operative method must be applied. |
