Increased Incidence and Severity of Postoperative Radiographic Hallux Valgus Interphalangeus With Surgical Correction of Hallux Valgus

Dixon, Alexis; Lee, Lydia C.; Charlton, Timothy P.; Thordarson, David B.

doi:10.1177/1071100715579905

Cited by 25 publications

(18 citation statements)

References 11 publications

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“…Within this study, an Akin osteotomy was conducted in 90% of the operations, which is higher than in most other previous studies but can be explained by the preoperative radiographic findings and probable regional differences. Another reason may be that all patients had an intraoperative radiographic control after shifting of the metatarsal head, which often demarks a HV interphalangeal position and leads to the decision to perform an additional Akin osteotomy . In most patients bridging bone trabecula could be seen within the first 6 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…The reader studies were performed using certified displays for diagnostic radiological review. The following parameters were accessed: Intermetatarsal 1–2 angle (IMA), hallux valgus angle (HVA), proximal and distal articular surfaces of the proximal phalanx angle (PDPAA), sesamoid position and degenerative changes according to Kellgren and Lawrence classification. Bony healing was defined as the osteotomy crossing bone trabecular in one view.…”

Section: Methodsmentioning

confidence: 99%

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Early results using a biodegradable magnesium screw for modified chevron osteotomies

Plaaß

Ettinger

Sonnow

et al. 2016

Journal Orthopaedic Research

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This is the first larger study analyzing the use of magnesium-based screws for fixation of modified Chevron osteotomies in hallux valgus surgery. Forty-four patients (45 feet) were included in this prospective study. A modified Chevron osteotomy was performed on every patient and a magnesium screw used for fixation. The mean clinical follow up was 21.4 weeks. The mean age of the patients was 45.5 years. Forty patients could be provided with the implant, in four patients the surgeon decided to change to a standard metallic implant. The AOFAS, FAAM and pain NRS-scale improved markedly. The hallux valgus angle, intermetatarsal angle and sesamoid position improved significantly. Seven patients showed dorsal subluxation, rotation or medial shifting of the metatarsal heads within the first 3 months. One of these patients was revised, in all others the findings were considered clinically not significant or the patients refused revision. This study shows the feasibility of using magnesium screws in hallux valgus-surgery. Surgeons starting with the use of these implants should be aware of the proper handling of these implants and should know about corrosion effects during healing and its radiographic appearance. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:2207-2214, 2016.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Early results using a biodegradable magnesium screw for modified chevron osteotomies

Plaaß

Ettinger

Sonnow

et al. 2016

Journal Orthopaedic Research

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“…According to the detected increased loss of correction in cases of increased preoperative PDPAA, an additional survey was taken. In respect to published data, we analyzed both cohorts in regard to the preoperative PDPAA [25, 26]. Underestimation of a hallux valgus interphalangeus deformity in bunion patients is common and is expressed by an increased PDPAA after metatarsal correction.…”

Section: Resultsmentioning

confidence: 99%

“…Arnold et al recommended Akin osteotomies if PDPAA surmounts 10° [25]. However, an average deterioration of 10° of PDPAA after metatarsal osteotomy has been detected as well [26]. This increase of 2° can be ascribed to a malprojection on the preoperative radiograph.…”

Section: Resultsmentioning

confidence: 99%

“…The frequent underestimation of a hallux valgus interphalangeus deformity in patients with a hallux valgus deformity has been shown intraoperatively as well [18]. An increase of PDPAA of 1.5° in patients who had undergone hallux valgus surgery without additional Akin osteotomy has been described recently [26]. The detected differences for PDPAA are meant to arise from a hyperpronation of the phalangeal bone in hallux valgus deformity resulting in a malprojection on the standing radiograph.…”

Section: Discussionmentioning

confidence: 98%

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Outcomes after scarf osteotomy with and without Akin osteotomy a retrospective comparative study

Kaufmann¹,

Hofmann

Ulmer

et al. 2019

J Orthop Surg Res

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Background The scarf osteotomy is a well-established surgical method for correcting a hallux valgus deformity. It is often combined with an Akin osteotomy. However, clear guidelines defining indication criteria are missing. The purpose of this study was to analyze the radiological outcome after scarf osteotomy in dependence of additional Akin osteotomy. Methods This study included 184 patients in whom a hallux valgus deformity was corrected with a scarf osteotomy (group S), and 63 patients in whom an additional Akin osteotomy was performed (group SA). Weight-bearing radiographs were evaluated preoperatively, postoperatively, after 6 weeks, after 3 months and at a follow-up with a mean of 45.4 months. Analysis was made for the following radiological parameters: the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), the proximal to distal phalangeal articular angle (PDPAA), and the position of the sesamoids as well as the joint congruity. Results Radiographic recurrence (HVA > 20°) was detected in 1 patient (1.6% of recurrence) in the SA group, and in 27 patients in the S group (14.7% of recurrence) at follow-up. Outcome between the two groups differed significantly showing reduced loss of HVA correction in the SA group ( p < 0.001). The subgroup with a preoperative PDPAA above eight degrees showed significant inferiority of outcome for the S group compared to the SA group. Conclusion Radiological outcome after scarf osteotomy is superior with concomitant Akin osteotomy. A preoperative PDPAA above eight degrees makes additional Akin osteotomy recommendable. Level of evidence Therapeutic, Level III, retrospective comparative series

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Lapidus-Arthrodese

et al. 2017

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The tarso-metatarsal 1 joint (TMT-I) arthrodesis is a treatment option or moderate to severe hallux valgus (HV) deformities. Instability of the TMT1 joint is still a debatable indication. Using stable osteosynthesis techniques allows early postoperative weight bearing. Plantar plating combined with a lag screw is the biomechanical most stable construct. An additional intermetatarsal screw can improve the horizontal stability. Clinical results are good and radiological parameters stay constant, even in the long term.

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Increased Incidence and Severity of Postoperative Radiographic Hallux Valgus Interphalangeus With Surgical Correction of Hallux Valgus

Abstract: Level III, retrospective comparative series.

Cited by 25 publications

References 11 publications

Early results using a biodegradable magnesium screw for modified chevron osteotomies

Early results using a biodegradable magnesium screw for modified chevron osteotomies

Outcomes after scarf osteotomy with and without Akin osteotomy a retrospective comparative study

Lapidus-Arthrodese

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