A retrospective study of the postsurgical results of 10 patients who had dorsiflexion osteotomy was undertaken. Patient satisfaction, clinical findings, and roentgenographic measurements were all carefully evaluated after an average duration of follow-up of 36.5 months. The procedure gave excellent results for all patients, with minimal loss of metatarsophalangeal motion and an average radiological metatarsal shortening of 2.3 mm and no postoperative metatarsalgia. The authors believe that the dorsiflexion osteotomy is a reasonable treatment for symptomatic Freiberg's disease. The procedure is reliable and not destructive, should further treatment be necessary.
A retrospective study of 15 Mitchell and 15 Chevron osteotomies was undertaken in order to compare the efficacy of these two procedures in the correction of hallux valgus. Patient satisfaction, clinical findings, and roentgenographic measurements were all carefully evaluated after follow-up periods of 21 +/- 5 months for the Chevron and 34 +/- 8 months for the Mitchell procedures. Differences observed were a better correction of the angle between the first and second metatarsals by the Mitchell osteotomy (2.3 vs 5.5 degrees) and a tendency to loose the correction in the immediate postoperative period for the Chevron osteotomy. However, no clinical superiority could be demonstrated, nor did patient satisfaction differ in the two techniques. The authors conclude that these procedures give essentially equivalent results. Although the outcome was generally considered satisfactory by the patient, nearly 40% of both groups had metatarsalgia in the lateral rays, which stresses the importance of carefully considering load distribution across the foot in planning any corrective surgery.
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