Repair of hallux valgus with a distal soft-tissue procedure and proximal metatarsal osteotomy. A long-term follow-up.

Mann, Roger A.; Rudicel, Sally; Graves, Stanley C.

doi:10.2106/00004623-199274010-00016

Cited by 402 publications

(323 citation statements)

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“…The dorsal malunion of the first metatarsal and transfer metatarsalgia after proximal metatarsal osteotomy have been reported in several studies [1,4,25,26]. In this study, no significant difference was observed in a mean decrease of the MT declination angle between the two groups; however, one patient had transfer metatarsalgia due to severe dorsal malunion in the K-wire group.…”

Section: Discussioncontrasting

confidence: 38%

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Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation

Park

Ahn

Kim

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to compare the results of hallux valgus surgery between feet fixed with Kirschner wires and those fixed with a plate and screws. Methods Between December 2008 and November 2009, 53 patients (62 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic moderate to severe hallux valgus deformity. Thirty-four patients (41 feet) were stabilised with Kirschner wires (K-wire group) and 19 patients (21 feet) were stabilised with a locking plate (plate group). Clinical results were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiographic parameters were compared between these groups. Recurrence rate at the last follow-up was compared between the K-wire and plate groups. Results Mean AOFAS score was lower in the plate group, however, the difference between the groups was not statistically significant in AOFAS score at the last follow-up. Hallux valgus angle and intermetatarsal angle were significantly larger in the plate group at the last follow-up. Mean 1-2 metatarsal (MT) distance on immediately postoperative radiographs was significant larger in the plate group. Four (9.8 %) of the 41 feet in the K-wire group and 7 (33.3 %) of the 21 feet in the plate group showed hallux valgus recurrence at the last follow-up. The plate group had a significantly higher risk of recurrence than the K-wire group. Conclusions Fixation of proximal chevron osteotomy using a plate and screws has a greater risk of hallux valgus recurrence than fixation using Kirschner wires.

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Section: Discussioncontrasting

confidence: 38%

“…Increased intermetatarsal angle can be adequately corrected with proximal metatarsal osteotomy [1,2]. However, transfer metatarsalgia often occurs due to the long moment arm of the distal fragment and insecure fixation.…”

Section: Introductionmentioning

confidence: 99%

Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation

Park

Ahn

Kim

et al. 2013

International Orthopaedics (SICOT)

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“…This angle remained constant from the time of union to the last follow-up. The mean pre-operative HVA was 39 (range 21-52) degrees, and the mean postoperative HVA was 11.8 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) degrees. The mean HVA at the last followup was 12.7 (range 6-30) degrees.…”

Section: Resultsmentioning

confidence: 99%

“…Osteotomy of the proximal metatarsal in combination with a distal soft tissue procedure is performed for the correction of moderate to severe hallux valgus [7,21]. It is recommended for correction of HVA greater than 20°and I-II IMA greater than 15° [2].…”

Section: Discussionmentioning

confidence: 99%

“…Different types of proximal metatarsal osteotomies have been used over the last decades including proximal crescentic osteotomy [7], proximal chevron osteotomy [8,9], scarf osteotomy [10,11], Ludloff osteotomy [12], Mau osteotomy [13], modified Mau [14], lateral closing wedge basal osteotomy [15] and medial opening wedge basal osteotomy [16].…”

Section: Introductionmentioning

confidence: 99%

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Proximal opening wedge metatarsal osteotomy for correction of moderate to severe hallux valgus deformity using a locking plate

Badekas

Georgiannos

Lampridis

et al. 2013

International Orthopaedics (SICOT)

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Purpose Hallux valgus is a complex deformity of the first metatarsophalangeal joint, with varus angulation of the first metatarsal, valgus deviation of the great toe and lateral displacement of the sesamoids and the extensor tendons. The aim of the surgery is to achieve correction of the varus deviation of the 1st metatarsal which is considered by some as the primary intrinsic predisposing factor to hallux valgus deformity. Methods We retrospectively reviewed 85 patients (107 feet) who underwent an opening wedge osteotomy of the 1st metatarsal for correction of moderate to severe hallux valgus and metatarsus primus varus. A medially applied anatomic precontoured locking plate was used for fixation of the osteotomy. Results The mean IMA was decreased from 15.8 (range 12-22) degrees to 7.8 (range 0-12) degrees. The mean preoperative HVA was 39 (range 21-52) degrees and the mean postoperative HVA was 11.8 (6-19) degrees. The preoperative AOFAS score was 52 (SD 3.1) and the postoperative score was 85 (SD 5.2). Conclusion The proximal opening wedge metatarsal osteotomy is a safe, effective and reproducible technique for correction of moderate to severe hallux valgus deformity. The use of a locking plate provides enough control at the fragments, enhancing healing of osteotomy and maintenance of the correction even with a violated proximal lateral cortex.

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Surgical interventions for treating hallux valgus and bunions

Dias

Godoy‐Santos

Ferrari

et al. 2020

Cochrane Database of Systematic Reviews

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Repair of hallux valgus with a distal soft-tissue procedure and proximal metatarsal osteotomy. A long-term follow-up.

Cited by 402 publications

References 0 publications

Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation

Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation

Proximal opening wedge metatarsal osteotomy for correction of moderate to severe hallux valgus deformity using a locking plate

Surgical interventions for treating hallux valgus and bunions

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