Comparison of Two Different Approaches to Treat a Hallux Valgus Deformity: Intramedullary Self-Locked Plates and Herbert Screws

Abstract

Background and objectives: Hallux valgus is a complex deformity of the first metatarsophalangeal joint characterized by varus deformity of the first metatarsal bone, valgus deformity of the big toe, and lateral deviation of the extensor tendons and sesamoid bones. Several surgical methods have been described for correction of the deformity. Different materials have been used for the fixation of osteotomy. We compared the functional, radiological, and pain results of intramedullary self-locked plates and Herbert screws for the treatment of a hallux valgus deformity. Materials and Methods: Distal metatarsals were treated with self-locking intramedullary plate–screw systems in 18 feet from 12 patients (Group 1) and with Herbert screws in 18 feet from 12 patients (Group 2). The hallux valgus angle (HVA) and intermetatarsal angle (IMA) in patients of Group 1 and 2 were examined radiologically during the pre- and postoperative periods. We also determined the American Orthopedic Foot and Ankle Society (AOFAS), EQ-5D General Life Quality Scale, and Visual Analogue Scale (VAS) scores during the pre- and postoperative periods and compared the scores between groups. Results: Post hoc test results of HVA and IMA angles measured after the operation were significantly higher in Group 2 than in Group 1. In each group, the AOFAS scores during the preoperation period were significantly lower than those during the postoperation period (p < 0.001). According to the post hoc test results, the VAS scores after the operation were significantly higher in Group 2 than in Group 1 (p < 0.001). Conclusions: For the surgical treatment of hallux valgus, operations using self-locked plates compared to a single screw are superior in terms of providing rigid stability and for functional, radiological, and pain scores.

The remarkably frequent use of EQ-5D in non-economic research

“…(i) Clinical trial: EQ-5D was employed as a primary or secondary outcome in an investigation, where two groups of patients were compared, and one of the groups received an experimental treatment. This trial could be randomized [8][9][10], or not randomized [11,12], where the control group received care-as-usual. (ii) Burden of illness study: EQ-5D was used to express the severity of the disease and/or the relationship between the severity of the disease and the different medical and background variables that were examined [13,14].…”

A Simple Corrective Strategy for Adolescent Hallux Valgus by Ilizarov Method

“…Newer implants like intramedullary self-locking plates are described, but limited by their cost and availability. 6 To our knowledge, there is only 1 report available on the use of the Ilizarov method in hallux valgus surgery. 7 Here the authors have used distal soft tissue procedure plus proximal bony procedure (either basal osteotomy or Chevron osteotomy).…”

“…Also, the placement of the plate is expected to result in undue soft tissue stripping and soft tissue complications. Newer implants like intramedullary self-locking plates are described, but limited by their cost and availability 6…”

Outcomes of V‐cut Osteotomy on the First Metatarsal Head Combined with Fixation in Mortise‐shaped Bone Groove‐Plasty and Akin Osteotomy on the First Toe for Hallux Valgus Correction

“…A surgery is necessary when the life quality of patients is reduced, which is caused by a series of reasons, such as foot pain, difficulties in wearing shoes, dysfunction of walking and running abilities. Nowadays, with the deepening of learning HV, there are more than 150 operative approaches invented by surgeons, comprising bunionectomy, metatarsals, phalangeal osteotomy, resection, interposition arthroplasty, and metatarsophalangeal joint arthrodesis 4 . Among them, osteotomies are the most important orthopedic surgeries, such as Chevron osteotomy, Scarf osteotomy, Michelle osteotomy and Akin osteotomy.…”

“…Nowadays, with the deepening of learning HV, there are more than 150 operative approaches invented by surgeons, comprising bunionectomy, metatarsals, phalangeal osteotomy, resection, interposition arthroplasty, and metatarsophalangeal joint arthrodesis. 4 Among them, osteotomies are the most important orthopedic surgeries, such as Chevron osteotomy, Scarf osteotomy, Michelle osteotomy and Akin osteotomy. Although numerous surgical techniques are used, none could completely avoid recurrence after correction, which is one of the most common problems after HV correction, 5 and many factors may lead to the problem, but there is no consensus.…”