engleski

Results of the treatment of Hallux Valgus with new three-dimensional distal metatarsal osteotomy

Purpose was to present clinical and radiological results of hallux valgus treatment with new distal three-dimensional first metatarsal osteotomy. The study included 129 female patients (152 feet) operated with new method at our department between April 2000 and December 2009. All patients were operated by first author because of hallux valgus deformity. Average age at the time of surgery was 44 years (18-70) and average follow-up 4.6 years (1-10). All results were evaluated according to AOFAS (Hallux Metatarsophalangeal-Interphalangeal Scale). Postoperative AOFAS increased from 47.8 to 92.6. Good and excellent result was achieved in 142 cases (93.4%), in 8 cases result was satisfactory and in two cases result was bad. Postoperative radiological results were significantly better (p<0, 001). Hallux valgus angle decreased from average 29.8° to 8.8°. First intermetatarsal angle decreased from 12.8° to 5.1°. Distal metatarsal articular angle decreased from 14.6° to -2.9°. Length of the first metatarsal was on average 6.5 mm shorter postoperatively. Position of medial sesamoid improved from 2.1° to 0.3°. Angle of the first metatarsal in sagittal plane improved from 22.9° to 28.5°. Pronation angle decreased postoperatively from 6.3° to -0.4°. New distal three-dimensional first metatarsal osteotomy is very successful in correcting all components of mild to moderate hallux valgus deformity. With this technique one can achieve predictable and longstanding results. Stabile osteosynthesis allows for generous fragment dislocation in all three planes together with quick healing and short and easy recovery. Complications are rare and easily manageable.

hallux valgus; osteotomy; 3d; new method

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