How I Use a Three-Dimensional Approach to Correct Hallux Valgus with a Distal Metatarsal Osteotomy

Winson, Daniel M.G.; Perera, Anthony

doi:10.1016/j.fcl.2018.02.002

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…Hallux valgus is an illness with a multifactorial pathogenesis, and the degree of rotation of the first metatarsal has become an increasingly important issue in the surgical treatment of this condition (4,7,13) . We agree with other authors that the careful evaluation and surgical treatment planning of hallux valgus must consider its three-dimensional nature (14) . The presence of a rounded metatarsal head in preoperative radiographs can indicate that a significant degree of pronation is present and must be corrected during surgery.…”

Section: Discussionsupporting

confidence: 89%

Radiographic analysis of the effects of first metatarsal rotation in hallux valgus surgery

2021

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Objective: To evaluate whether the initial degree of metatarsal rotation interferes with the surgical correction of severe hallux valgus. Methods: A retrospective study was performed using weight-bearing AP radiographs to measure first metatarsal rotation based on the shape of the lateral edge of the metatarsal head and the hallux valgus (HVA) and intermetatarsal (IMA) angles. Participants were then classified into two groups. Those with less rotational deformity were placed in the negative pronation group, while those with greater rotational deformity were placed in the positive pronation group. Mean HVA and IMA correction were calculated and compared between groups. Participants underwent the modified Lapidus procedure with correction of pronation. Results: Data were collected for 26 feet with hallux valgus. The negative and positive pronation groups contained 14 and 12 feet, respectively. Successful surgical correction of pronation was observed in 11 of the 12 feet, which were ultimately classified in the negative pronation group based on postoperative radiographs. The negative pronation group showed a mean difference of 15.05o in the HVA and 4.20o in the IMA. The positive pronation group showed a mean difference of 14.22o in the HVA and 3.2o in the IMA. These values did not significantly differ between groups. Conclusion: The initial degree of pronation does not affect the degree of angular correction as long as metatarsal rotation is also addressed. Level of Evidence IV; Diagnostic Studies; Case Series.

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Section: Discussionsupporting

confidence: 89%

Radiographic analysis of the effects of first metatarsal rotation in hallux valgus surgery

2021

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“…In mild deformities, a minimally invasive osteotomy has been described to address rotation. 17 These methods are all efficient in addressing the rotational deformity but are more technically demanding and invasive for the patient. The chevron osteotomy has, since first described in 1976, gained acceptance and reliability with many foot and ankle surgeons, being one of the most common procedures used for treating mild to moderate HV deformities worldwide.…”

Section: Discussionmentioning

confidence: 99%

“…In more severe deformities, the Lapidus procedure, 14 oblique pure rotational osteotomies, or the intermediate scarf procedure are hitherto described techniques addressing the HV deformity in a 3-dimensional way. [15][16][17] For the less severe deformities, few methods addressing the coronal malalignment in its entirety has been described.…”

Section: Introductionmentioning

confidence: 99%

A Cadaveric Study Verifying the Potential of a Rotational Biplanar Chevron Osteotomy to Correct the 3-Dimensional Hallux Valgus Deformity

Hamre

Molund

Nilsen

2022

Foot & Ankle Specialist

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Introduction Metatarsal pronation is present in 87% of patients with hallux valgus (HV) deformity. The chevron osteotomy is commonly used worldwide to correct mild to moderate HV deformities. Many modifications have been described, but few address the rotational deformity of the first metatarsal. The rotational biplanar chevron osteotomy (RBCO), described by M. Prado et al, presents a variation of a biplanar chevron osteotomy that can be used to address first metatarsal rotation. The objective of this study is to investigate and verify the technique of the RBCO. Methods We conducted our study performing an RBCO on 9 cadaveric limbs. The technique uses a medial-based wedge parallel to the plantar limb of the osteotomy to make the distal fragment free to correct rotation. A goniometer was used by 2 individual surgeons to control the rotational correction achieved. Results The osteotomy was considered simple to perform and we experienced no complications, such as fractures or instability. The result was satisfactory alignment and adequate stability. On average, a 2 mm wedge resulted in 11° of rotational correction. Conclusion We predict that RBCO can safely be used for correcting the metatarsal rotation when necessary in mild to moderate HV deformity foot. Levels of Evidence: Level IV

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“…Multiple authors posit that rotational correction—judged either by sesamoid position on the anteroposterior view,2 with a dedicated sesamoid view,3,4 or with cross-sectional imaging1,5—is key to preventing recurrence of the deformity 6–8. To this end, various techniques have been devised and well described in the literature to address the triplanar HV deformity 9–16…”

Section: Historical Perspectivementioning

confidence: 99%

Proximal Rotational Metatarsal Osteotomy for Treatment of Hallux Valgus: A Technique Guide

Wallace

Hunt

2021

Techniques in Foot &Amp; Ankle Surgery

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There is increasing interest in rotational correction of the first metatarsal during hallux valgus correction. This article provides a technique guide for the proximal rotational metatarsal osteotomy technique, which corrects both the intermetatarsal angle and the rotational deformity with a single oblique osteotomy. Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.

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How I Use a Three-Dimensional Approach to Correct Hallux Valgus with a Distal Metatarsal Osteotomy

Cited by 5 publications

References 22 publications

Radiographic analysis of the effects of first metatarsal rotation in hallux valgus surgery

Radiographic analysis of the effects of first metatarsal rotation in hallux valgus surgery

A Cadaveric Study Verifying the Potential of a Rotational Biplanar Chevron Osteotomy to Correct the 3-Dimensional Hallux Valgus Deformity

Proximal Rotational Metatarsal Osteotomy for Treatment of Hallux Valgus: A Technique Guide

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