Plate Fixation for Crescentic Metatarsal Osteotomy in the Treatment of Hallux Valgus: An Eight-Year Followup Study

Chow, Francis Y; Lui, Tun Hing; Kwok, Kin Wa; Chow, Yuk-Yin

doi:10.3113/fai.2008.0029

Cited by 23 publications

(6 citation statements)

References 17 publications

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“…When the first-second intermetatarsal angle exceeds 15 degrees it is generally believed that this degree of deformity cannot be corrected by a distal bunion procedure, but rather by some type of proximal metatarsal osteotomy or more proximal tarsometatarsal arthrodesis. 2,5,7,8,11,12,17,21,22 Whether first ray hypermobility exists as an etiological factor still remains controversial. 2,4,12,13,14 However, in severe bunion deformity wherein there is excessive metatarsus primus varus, successful correction has been well-established in the literature, going back to the original article by Lapidus.…”

Section: Discussionmentioning

confidence: 99%

“…2,3,7,11,12,14,21,24 Several techniques have been used for fixation including Kirschner wires, partially threaded cancellous screws, Steinman pins, 3.5-mm or 4.5-mm cortical screws, and 1/4 tubular plates or so-called "H-plates." 5,20 Outcome studies have demonstrated a high satisfaction rate with this procedure, but the reported incidence of nonunion or malunion has ranged from 5% to 15%. 8 Sangeorzan and Hansen reported a revision rate of 13% for mal-or nonunion following Lapidus bunion surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Arthrodesis of the First Metatarsocuneiform Joint: A Comparative Study of Fixation Methods

Scranton¹,

Coetzee²,

Carreira³

2009

Foot Ankle Int.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Arthrodesis of the First Metatarsocuneiform Joint: A Comparative Study of Fixation Methods

Scranton¹,

Coetzee²,

Carreira³

2009

Foot Ankle Int.

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“…A total of 4607 studies were excluded by examining their titles and/or abstracts, and a further 143 studies were excluded after full-text review. This left 17 eligible studies 1,3-6,9,11-14,16-20,22-24,27,30,31,33,34,36-39 that reported on 18 data sets, representing a total of 2105 feet (Table 1, Figure 1). Of the 18 data sets, 9 assessed outcomes of Chevron osteotomies, 3 assessed Mitchell osteotomies, 2 assessed Bösch osteotomies, and 4 assessed “other” osteotomies: 1 Hohmann osteotomy, 1 percutaneous distal retrocapital osteotomy, 1 minimally invasive technique, and 1 minimally invasive intramedullary nail device.…”

Section: Resultsmentioning

confidence: 99%

Recurrence Rates With Longer-Term Follow-up After Hallux Valgus Surgical Treatment With Distal Metatarsal Osteotomies: A Systematic Review and Meta-analysis

Lalevée

Rooij

Boublil³

et al. 2023

Foot Ankle Int.

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Background: Recurrence of hallux valgus (HV) following corrective surgery is a frequent concern. A recent systematic review estimated recurrence of HV in only 4.9%, which may be an underestimation, as most included studies had short- to mid-term follow-up. The purpose of this systematic review and meta-analysis was to assess long-term outcomes of distal osteotomies of the first metatarsal (M1) to treat HV without inflammatory disease or degenerative arthritis, and to assess HV recurrence rates reported in studies that had a minimum follow-up of 5 years. Methods: This systematic review conforms to the PRISMA guidelines. The authors conducted a search using PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. Studies that report outcomes of distal osteotomies of the M1 for noninflammatory and nondegenerative HV at a minimum follow-up of 5 years. Results: We found 17 eligible studies comprising 18 data sets, reporting outcomes of 4 categories of osteotomies: Chevron, Mitchell, Bösch, and “others.” The HV recurrence rate was 64% considering the threshold of >15 degrees hallux valgus angle (HVA), 10% having >20 degrees, and 5% having >25 degrees. Conclusion: At a minimum of 5 years following distal osteotomies of the M1, the mean weighted postoperative HVA was significantly higher for Mitchell osteotomies compared with the 3 other osteotomies reviewed. There were otherwise no significant differences in recurrence rates using the 3 HVA thresholds, or intermetatarsal angle among any of the surgical techniques reported in 2 or more studies. The pooled HV recurrence rates considering the various thresholds of HVA were as follows: 64% having >15 degrees, 10% having >20 degrees, and 5% having >25 degrees. The recurrence rates in the long term for all categories of surgical procedures suggest that better understanding of pathogenesis and prognosis of HV is required before modifying or introducing new surgical techniques. Level of Evidence: Level IV, meta-analysis.

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“…Regarding postoperative treatment, most authors allow full weightbearing in a stiff‐soled shoe or cast during the first two weeks after surgery, while some only allow heel weightbearing [4, 7, 8, 11]. Early ambulation with full weightbearing reduces the risk of deep vein thrombosis and prevents muscular atrophy.…”

Section: Discussionmentioning

confidence: 99%

“…Over the past 10 years, some surgeons have increasingly used locking plates instead of a single screw for stabilisation of the osteotomy with the assumption of better postoperative stability and preserved length of the first metatarsal. In addition, fixation with a plate has been described as technically less challenging [3][4][5][6][7][8]. However, we prefer a proximal openwedge chevron-like osteotomy combined with medial bone impaction and single screw stabilisation [3].…”

Section: Introductionmentioning

confidence: 99%

Proximal metatarsal osteotomy for hallux valgus: an audit of radiologic outcome after single screw fixation and full postoperative weightbearing

Mittag¹,

Leichtle²,

Meisner

et al. 2013

Journal of Foot and Ankle Research

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BackgroundProximal metatarsal osteotomy combined with a distal soft-tissue procedure is a common treatment for moderate to severe hallux valgus. Secure stabilisation of the metatarsal osteotomy is necessary to avoid complications such as delayed union, nonunion or malunion as well as loss of correction. The aim of this study was to report our results using a single screw for stabilisation of the osteotomy.MethodsWe retrospectively reviewed 151 patients with severe hallux valgus who were treated by the above mentioned way with full postoperative weightbearing in a stiff soled shoe. Mean age of patients at time of surgery was 54 years, 19 patients were male and 132 female. Assessment of clinical and radiographic results was performed after 2 days and 6 weeks. Results were also correlated to the experience of the performing surgeon.ResultsMean preoperative HVA (hallux valgus angle) was 36.4 degrees, and then 3.5 degrees 2 days and 13.4 degrees 6 weeks after the procedure (p < 0.001). Mean preoperative IMA (intermetarsal angle) was 16.8 degrees, and then 6.4 degrees after 2 days and 9.8 degrees after 6 weeks (p < 0.001). Mean preoperative first metatarsal length of 56.4 mm decreased to 53.6 mm after 6 weeks. Possible non-union of the osteotomy was observed in 4 patients (2.6%) after 6 weeks. Performing residents (n = 40) operated in 65 minutes and attending surgeons (n = 111) in 45 minutes, with no significant differences in radiographic measurements between both groups.ConclusionsSingle screw stabilisation of proximal chevron osteotomy is a reliable method for treating severe hallux valgus deformities with satisfactory results.

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Plate Fixation for Crescentic Metatarsal Osteotomy in the Treatment of Hallux Valgus: An Eight-Year Followup Study

Abstract: Dorsal plate fixation of crescentic metatarsal osteotomy is a technically easier procedure. Equally good results can be achieved when compared with screw fixation methods, and the results can be maintained long-term.

Cited by 23 publications

References 17 publications

Arthrodesis of the First Metatarsocuneiform Joint: A Comparative Study of Fixation Methods

Arthrodesis of the First Metatarsocuneiform Joint: A Comparative Study of Fixation Methods

Recurrence Rates With Longer-Term Follow-up After Hallux Valgus Surgical Treatment With Distal Metatarsal Osteotomies: A Systematic Review and Meta-analysis

Proximal metatarsal osteotomy for hallux valgus: an audit of radiologic outcome after single screw fixation and full postoperative weightbearing

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