Follow-up of the Isolated Medial Approach to Hallux Abducto Valgus Correction Without Interspace Release

Abstract

A retrospective radiographic review was performed of 29 patients (37 feet) who underwent an isolated medial approach for correction of hallux abducto valgus deformity from March 1993 to November 1998. Only those patients who had a traditional Austin-type osteotomy with a reducible first metatarsophalangeal joint and flexible first ray were included in the study. The average follow-up period for the entire study group was 18.4 months, with 13 patients (44.83%; 17 feet) having a follow-up period of longer than 2 years. The average decrease in the intermetatarsal angle was 9.89 degrees, and the average decrease in the hallux abductus angle was 14.0 degrees, results that correlated well with those of other studies on correction of hallux abducto valgus. No clinical or radiographic recurrence of hallux abducto valgus was noted throughout the follow-up period. The authors believe that an isolated medial approach to hallux abducto valgus correction without a lateral interspace release yields predictable results when performed in appropriately selected patients.

The Relationship Between the Sesamoid Complex and the First Metatarsal After Hallux Valgus Surgery Without Lateral Soft-Tissue Release: A Prospective Study

“…It could explain the recommendation of Oloff and Bocko (54). In contrast, Boberg and Judge (25), in a study similar to ours, did not recommend lateral soft tissue release for patients in whom the sesamoid complex had not luxated. In their series, the mean metatarsophalangeal angle was 23 , and all the angles were <38 .…”

“…They recommended taking measurements from tangential radiographs using the Walter-M€ uller view. Some investigators have agreed with them (22,25); however, the Walter-M€ uller view requires dorsiflexion of the MTPJ (1,25,29), which moves the sesamoid complex distally and dorsally.…”

“…Lee et al (43) and Granberry and Hickey (44) associated soft tissue release with greater postoperative stiffness of the MTPJ (25). They reported that soft tissue release should be contraindicated in cases of preoperative MTPJ limitation, despite the greater angular correction provided by the lateral soft tissue release.…”

“…The position of the sesamoid complex relative to the first metatarsal has been studied by several investigators (9,13,14,23,(25)(26)(27)(28)(29). In 1923, Silver (5) emphasized the importance of restoring the relationship between the first metatarsal and the sesamoid complex when correcting hallux valgus surgically.…”

Sequenzielles laterales Weichteilrelease an der Großzehe: eine anatomische Studie

“…Zuvor arbeiteten vor allem Silver [3] und Schede [4] mit Weichteiltechniken beim Hallux valgus. Die Wichtigkeit der Balancierung der am Metatarsale 1 (MT 1) und der an der Grundphalanx anhängigen Weichteile ist mittlerweile anerkannt und etabliert [1]. Als typische Indikation des lateralen Releases gilt die inkongruente Hallux-valgus-Deformität [5].…”