High Rate of Recurrence Following Proximal Medial Opening Wedge Osteotomy for Correction of Moderate Hallux Valgus

Iyer, Sravisht; Demetracopoulos, Constantine A.; Sofka, Carolyn M.; Ellis, Scott J.

doi:10.1177/1071100715577195

Cited by 46 publications

(30 citation statements)

References 19 publications

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“…What is more, the majority of the published studies presented outcome after linear distal metatarsal osteotomies [ 14 ], which might have an impact on the joint line. Iyer et al found higher recurrence rates in individuals with pathological joint lines, whereas another study demonstrated a probability for a metatarsal misload after Reverdin-Isham procedures [ 26 , 27 ]. Other authors showed already good clinical and radiological results with a minimally invasive chevron technique, but our analysis is the first to compare a minimally invasive chevron type and an open chevron osteotomy in a randomized manner [ 9 , 10 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive versus open chevron osteotomy for hallux valgus correction: a randomized controlled trial

Kaufmann¹,

Dammerer

Heyenbrock

et al. 2018

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to compare a minimally invasive chevron osteotomy technique (MIS group) and the wellestablished open chevron technique (OC group) for correction of hallux valgus deformity. Methods Patients who were scheduled to undergo a hallux valgus surgery by means of a distal chevron osteotomy were randomly assigned to one of the two groups. Pre-operatively, six weeks, 12 weeks, and nine months post-operatively the following outcome parameters were determined: Visual Analog Scores (VAS) of pain, the American Orthopedic Foot and Ankle Society (AOFAS) forefoot score, radiographic outcome measures, range of motion (ROM), and patient satisfaction. Results Forty-seven cases were analyzed (25 MIS group; 22 OC group). Both operative techniques achieved significant correction of the hallux deformity. The intermetatarsal angle (IMA) improved from 15.1°to 5.8°in the OC and from 14°to 6.8°in the MIS group, whereas the hallux valgus angle (HVA) improved from 28.3°to 8.5°in the OC versus 26.4°to 6.9°in the MIS group. No significant differences were observed between the groups by any of the determined outcome parameters. Regarding patient satisfaction, statistically significant differences were found between MIS and open surgery 12 weeks post-operatively in favour of the MIS group (p = 0.022). Conclusion With the minimally invasive chevron osteotomy, radiological and clinical outcome is comparable to the open technique.

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Section: Discussionmentioning

confidence: 99%

Minimally invasive versus open chevron osteotomy for hallux valgus correction: a randomized controlled trial

Kaufmann¹,

Dammerer

Heyenbrock

et al. 2018

International Orthopaedics (SICOT)

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“…Because MPV is the product of failed ligaments and a destabilized first metatarsal, its restabilization is just as important as its realignment (14). Restoration of first metatarsal stability has been sufficiently discussed and understood; however, the recurrence of the MPV deformity remains mostly unresolved (15,16). Although arthrodesis of the metatarsocuneiform joint using the Lapidus procedure has thus been recommended to help prevent recurrence (9), recurrence can still develop (17).…”

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confidence: 99%

Can the Syndesmosis Procedure Prevent Metatarsus Primus Varus and Hallux Valgus Deformity Recurrence? A 5-Year Prospective Study

Lam

2018

The Journal of Foot and Ankle Surgery

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One of the main objectives of hallux valgus surgery is correction of the metatarsus primus varus deformity by osteotomy, arthrodesis, or soft tissue correction. The syndesmosis procedure uses intermetatarsal cerclage sutures to realign the first metatarsal and also induces a syndesmotic bonding between the first and second metatarsals to prevent metatarsus primus varus deformity recurrence. The purpose of the present study was to demonstrate radiologic evidence of the effectiveness of the syndesmosis concept and to identify the incidence and nature of deformity recurrence. A total of 55 feet from 60 consecutive procedures were followed regularly at 6 fixed points for 5 years. The radiologic inclusion criterion was a first intermetatarsal angle >9° or metatarsophalangeal angle >20°. The initial postoperative radiographs showed significant correction of the intermetatarsal angle from a preoperative average of 14.5° to 4.3° (p < .0001). It had increased to 7.0° during the first 6 postoperative months but remained within the normal upper limit of 9° and exhibited no further significant changes for the subsequent 4.5 years (p = .0792). Hallux valgus deformity correction also correlated with metatarsus primus varus deformity correction. Three (5%) second metatarsal stress fractures occurred, and all recovered uneventfully. In conclusion, we have report the findings from a detailed medium long-term follow-up study showing, to the best of our knowledge, for the first time that metatarsus primus varus and hallux valgus deformities can be effectively corrected and maintained using a specific surgical technique. Also included are 6 relevant radiographs and photographs of the included and excluded feet in the online Supplementary Material for reference.

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“…Reasons for poor outcomes can be multifactorial, and these risk factors can interact with each other to complicate matters. 9 For example, a high preoperative hallux valgus angle is associated with recurrence of hallux valgus deformity 10 while it has also been shown that the metatarsus adductus angle is associated with the hallux valgus angle. 11,12 The goal of this study is to observe the relationship between underlying metatarsus adductus deformity and the outcomes of hallux valgus corrective procedures, while adjusting for other covariates.…”

mentioning

confidence: 99%

Correction of Hallux Valgus Deformity in Association With Underlying Metatarsus Adductus Deformity

Shibuya

Jupiter

Plemmons

et al. 2017

Foot & Ankle Specialist

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High Rate of Recurrence Following Proximal Medial Opening Wedge Osteotomy for Correction of Moderate Hallux Valgus

Abstract: Level IV, retrospective case series.

Cited by 46 publications

References 19 publications

Minimally invasive versus open chevron osteotomy for hallux valgus correction: a randomized controlled trial

Minimally invasive versus open chevron osteotomy for hallux valgus correction: a randomized controlled trial

Can the Syndesmosis Procedure Prevent Metatarsus Primus Varus and Hallux Valgus Deformity Recurrence? A 5-Year Prospective Study

Correction of Hallux Valgus Deformity in Association With Underlying Metatarsus Adductus Deformity

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