Mohsen Movahedi Yeghaneh, MD
Abstract
Background: The aim of this study was to compare the results of percutaneous sub capital metatarsal osteotomy with open distal chevron osteotomy of first metatarsal in hallux valgus surgery. Methods: In a clinical trial study, 29 patients with bilateral hallux valgus (58 foot) were selected randomly. ...
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Background: The aim of this study was to compare the results of percutaneous sub capital metatarsal osteotomy with open distal chevron osteotomy of first metatarsal in hallux valgus surgery. Methods: In a clinical trial study, 29 patients with bilateral hallux valgus (58 foot) were selected randomly. All patients were female and the average age was 31 years old (17-55 yrs). The average time of follow-up was 13 months (6-20 months). Hallux valgus angle (HVA) up to 40° and intermetatarsal angle (IMA) up to 17° were included. For each patient, a percutaneous sub capital osteotomy on one foot and an open distal chevron osteotomy on the other foot were performed at the same time and by the same surgeon. Left or right side deformities were randomly selected for MIS or open procedure. Results: The average HVA correction was similar in both groups but the IMA correction was better in the open distal chevron osteotomy. In the chevron osteotomy, both patient's and surgeon's satisfaction level were in the similar range. In the MIS technique, the level of satisfaction varied between the surgeon and the patient. 86% of the patients were completely satisfied but the surgeon was fully satisfied in only 38% of the cases. Conclusions: Distal chevron osteotomy is recommended as a reliable corrective technique in mild to moderate hallux valgus but the percutaneous sub capital osteotomy can still be considered in selected patients with relatively low IMA.
Mahmood Bahari, MD; Hassan Rahimi, MD; Mohammad Gharedaghi, MD; Javad Afzali, MD
Abstract
Background: ِِDouble osteotomy of first metatarsal has been advocated as a procedure of choice for severe hallux valgus in adolescent age group. We would like to report our experience with such an osteotomy in Meshhad.Methods: Over a five year period (1999-2004), 26 feet in 17 adolescents - mean age ...
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Background: ِِDouble osteotomy of first metatarsal has been advocated as a procedure of choice for severe hallux valgus in adolescent age group. We would like to report our experience with such an osteotomy in Meshhad.Methods: Over a five year period (1999-2004), 26 feet in 17 adolescents - mean age of 15.5 years - with moderate to severe hallux valgus underwent double first metatarsal osteotomies. With a mean follow-up of 26 months, the cases were evaluated by American Orthopaedics Foot & Ankle Society Hallux Metatarso-phalangeal-interphalangeal scale (AOFAS/HMI). In this study pre and post hallux valgus (HVA), intermetatarsal (IMA), and distal metatarsal articular (DMAA) angles, and the relation between the angles and patient satisfaction were evaluated.Results: The mean angular corrections for hallux valgus (HVA), intermetatarsal (IMA) and distal metatarsal articualr (DMAA) angles were 26.65, 6.20 and 5.55 degrees respectively. Four cases could not be reached and from the remaining 13 patients, 2 cases had required second surgery for non-:::union::: and 3 cases had stiffness in MTP (metatarsophalangeal) joints. Sixteen cases reported good to excellent results.Conclusions: Double first metatarsal osteotomy for severe hallux valgus is a reasonable procedure in adolescents which maintains the correction. Non-:::union::: and first MTP joint contractures are the two main side effects.
