Severe Hallux Valgus With Coalition of the Hallux Sesamoids Treated With Modified Lapidus Procedure: A Case Report

Kurashige, Toshinori; Suzuki, Sohtaro

doi:10.1177/1938640017703187

Cited by 1 publication

(1 citation statement)

References 7 publications

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“… 9 , 10 In addition, the excessive length of first ray, 11 anatomical defect (skeletal immaturity, hypermobility and congruent joint), systemic factors (rheumatoid arthritis, gout, hyper laxity, neuromuscular condition and cerebrovascular accident), individual lifestyles (such as smoking and continued wearing of high heels) are also important factors of HV recurrence. As for the surgical factors, incomplete reduction of the medial sesamoids 12 and the incomplete correction of the first ray are important factors causing the recurrence. From our perspective, maintaining the alignment of the first metatarsal is of great importance.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of V‐cut Osteotomy on the First Metatarsal Head Combined with Fixation in Mortise‐shaped Bone Groove‐Plasty and Akin Osteotomy on the First Toe for Hallux Valgus Correction

Jiao

Gan

et al. 2022

Orthopaedic Surgery

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Objective Hallux valgus (HV) is a common foot deformity, and recurrence is one of the most serious complications after HV correction. As a result, the surgical technique with a lower recurrence rate is a dream. The purpose of the article should be to observe the correction effect of hallux valgus using a novel “V‐cut” osteotomy on the first metatarsal head combined with fixation in mortise‐shaped bone groove‐plasty technique. Methods Twenty‐three consecutive patients (40 feet) with HV were included from March 2019 to May 2020, who were all treated using single screw fixation with V‐cut osteotomy on the first metatarsal head combined with mortise‐shaped metatarsal bone groove‐plasty and Akin osteotomy on the first toe for hallux valgus correction. With a mean follow‐up time of 21.7 months, the visual analogue scale (VAS) score and American Orthopedic Foot and Ankle Society (AOFAS) forefoot score and the changes of the hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA) were evaluated during the clinical follow‐up. The paired t test was used for analytical statistics. Results The VAS score improved from 6.78 ± 1.74 to 1.87 ± 1.45 and the AOFAS score improved from 53.9 ± 12.3 preoperatively to 94.7 ± 6.8 in the latest follow‐up postoperatively (P < 0.01). Besides, the HVA improved from 30.0 ± 6.1° to 5.7 ± 2.8° (P < 0.01); the IMA changed from 13.1 ± 2.8° into 3.3 ± 1.6° (P < 0.01); and the DMAA ameliorated from 27.0 ± 8.4° to 5.9 ± 3.5° (P < 0.01). Only five toes had slight numbness and stiffness in early postoperative period, and these symptoms disappeared completely at 6 months after the surgery. Only one foot was corrected to excess. One screw stern protruding beneath the skin happened, which needed secondary screw removal under local anesthesia. Conclusions Single screw fixation with V‐cut osteotomy on the first metatarsal head combined with fixation in mortise‐shaped metatarsal bone groove‐plasty and Akin osteotomy on the first toe is an effective way with low recurrence rate for HV correction.

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