Moderate to severe hallux valgus deformity: correction with proximal crescentic osteotomy and distal soft-tissue release

2000 ◽  
Vol 120 (7-8) ◽  
pp. 397-402 ◽  
Author(s):  
R. Zettl ◽  
H.-J. Trnka ◽  
M. Easley ◽  
M. Salzer ◽  
P. Ritschl
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Deformity Correction ◽  
Valgus Deformity ◽  
Soft Tissue Release ◽  
Hallux Valgus Deformity ◽  
Severe Hallux Valgus

scholarly journals Rotated Insertion Metatarsal Osteotomy with Distal Soft Tissue Procedure for Severe Hallux Valgus Deformity ―Novel Procedure of the 1st metatarsal osteotomy―

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Norihiro Samoto ◽  
Yasuhito Tanaka ◽  
Ryuhei Katsui ◽  
Kazuya Sugimoto
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Locking Plate ◽  
Valgus Deformity ◽  
Metatarsal Osteotomy ◽  
Rigid Fixation ◽  
Soft Tissue Procedure ◽  
Hallux Valgus Deformity ◽  
The Mean ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Hallux valgus deformity is recently a common disease involved in the foot and ankle and many procedures are recommended globally. However it is controversial about the operative treatment for severe hallux valgus. Many authors have reported the technical difficulties and various complications. We performed rotated insertion metatarsal osteotomy with the distal soft tissue procedure for severe hallux valgus deformity since January 2008. The purpose of this study is to evaluate the medium-term outcome of this procedure. Methods: Two hundred thirty-two feet in 173 patients were enrolled in this study and followed them up for a mean of 44.5 months. The mean age at the operation was 64.5 years. Hallux valgus angle(HVA) and intermetatarsal angle(IMA) were measured. This procedure consists of the rotated insertion metatarsal osteotomy and the distal soft tissue procedure. This diaphysial longitudinal metatarsal oblique osteotomy was performed from proximally- medial site of the first metatarsal directed to distally- lateral site through the dorsal exposure. The tip of osteotomized proximal metatarsal was formed at the dorso-distal site to insert in the central intramedullary aspect of osteotomized distal metatarsal. The second triangular cut of one third of dorso-plantar thick was made about 10 to 15 mm length from the lateral tip of osteomized proximal metatarsal. The internal fixation was performed with locking plate with screws. As a result, osteotomized sites were locked each other such as a puzzle. Results: The mean preoperative HVA and IMA were 43.8 degrees and 20.1 degrees. The mean postoperative HVA and IMA were decreased to 9.0 degrees and 6.1 degrees. AOFAS scores improved from 49.3 to 89.7. All cases were obtained complete union. Postoperative displacement was in 12 feet (5.2%) and followed under-correction (or recurrence). Overcorrection (hallux varus) occurred in 10 feet (4.7%). Wound healing was delayed in 21 feet (9.1%). In general, we found no severe complication and unsatisfactory result. Conclusion: This procedure provided satisfactory result for severe hallux valgus deformity. Especially the rigid fixation at the site of metatarsal osteotomy was much stronger because of the insertion and locking plate. However the further more outcomes in detail are essential for longer term follow-up.

Distal Chevron Osteotomy with Distal Soft Tissue Procedure for Moderate to Severe Hallux Valgus Deformity

2010 ◽  
Vol 31 (8) ◽  
pp. 683-688 ◽  
Author(s):  
Long Bin Bai ◽  
Keun Bae Lee ◽  
Chang Young Seo ◽  
Eun Kyoo Song ◽  
Taek Rim Yoon
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Valgus Deformity ◽  
Soft Tissue Procedure ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Severe Hallux Valgus

scholarly journals Os Intermetatarseum May not Interfere with Metatarsus Primus Varus Deformity Correction: A Case Report

2018 ◽  
Vol 25 (1) ◽  
pp. 24-28
Author(s):  
Daniel Y. Wu
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Hallux Valgus ◽  
Deformity Correction ◽  
Varus Deformity ◽  
Valgus Deformity ◽  
Hallux Valgus Deformity ◽  
Os Intermetatarseum ◽  
First Time

It has been believed that the correction of metatarsus primus varus (MPV) deformity of hallux valgus foot using nonosteotomy procedures would be compromised by the presence of os intermetatarseum (OI). Therefore, no soft tissue procedure has ever been reported for the correction of MPV deformity of hallux valgus foot. This is a case report of a female patient with bilateral hallux valgus deformity and also a large OI of her left foot that was corrected, satisfactorily and simultaneously, with a soft tissue technique called syndesmosis procedure, without osteotomy or OI resection. Excellent feet function was observed for 2 years until her last follow-up examination without any symptoms or signs of problems relating to the OI in her left foot. This case report demonstrated for the first time that OI may not interfere with proper MPV deformity correction because it can be preexisting and X-ray can be misleading.

Percutaneous Chevron and Akin (PECA) Osteotomies for Severe Hallux Valgus Deformity With Mean 3-Year Follow-up

2021 ◽  
pp. 107110072110084
Author(s):  
Thomas L. Lewis ◽  
Robbie Ray ◽  
Peter Robinson ◽  
Paul M. C. Dearden ◽  
Thomas J. Goff ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Deformity Correction ◽  
Valgus Deformity ◽  
Percutaneous Surgery ◽  
Residual Deformity ◽  
Hallux Valgus Deformity ◽  
Patient Reported ◽  
The Mean ◽  
Severe Hallux Valgus

Background: Patients with severe hallux valgus deformity present technical and operative challenges with high rates of recurrence and residual deformity. The clinical and radiologic outcomes of percutaneous surgery for severe hallux valgus are not known. Methods: A retrospective review of consecutive patients with a hallux valgus angle (HVA) >40 degrees or intermetatarsal angle (IMA) >20 degrees who underwent third-generation percutaneous chevron and Akin osteotomy (PECA) for hallux valgus deformity correction. Results: Between December 2012 and August 2019, 59 feet in 50 patients underwent PECA. Preoperative and follow-up radiographic data were available for 53 feet (89.8%). Postoperative clinical patient-reported outcome measures and satisfaction results were available for 51 feet (86.4%). The mean clinical and radiographic follow-up was 3.1 years and the mean postoperative Manchester-Oxford Foot Questionnaire Index score was 15.1. There was a statistically significant improvement ( P < .001) in both IMA and HVA following surgery (IMA 17.5-5.1 degrees; HVA 44.1-11.5 degrees). All patients reported they were satisfied with their outcome, with 76.8% reporting they were highly satisfied. The hallux valgus recurrence rate was 7.5%. Conclusion: Percutaneous surgery for severe hallux valgus deformity can achieve a large deformity correction, patient satisfaction, and quality of life, with reasonable rates of residual deformity and low rates of recurrence. Level of Evidence: IV

Clinico-radiological Results of Distal Chevron Osteotomy without Lateral Soft Tissue Release in Mild to Moderate Hallux Valgus Deformity

2021 ◽  
Vol 23 (4) ◽  
pp. 287-293
Author(s):  
Mohd Rafeeq Wani ◽  
Mohd Iqbal Wani ◽  
Arshid Bashir ◽  
Manzoor Ahmad Halwai ◽  
Stanzin Sonum ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Valgus Deformity ◽  
Soft Tissue Release ◽  
Average Value ◽  
Radiological Results ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
A Prospective Study

Background. The study was done to evaluate short term clinico-radiological results of distal chevron oste­otomy without lateral soft tissue release in mild to moderate hallux valgus. Materials and methods. This was a prospective study consisting of a total of 35 cases with mild to moderate hallux valgus deformity. All these patients were treated by distal chevron osteotomy without lateral soft tissue release. Results. In our study, the average value of hallux angle preoperatively was 32° (range, 24°-40°) and at final follow-up it was 14° (range, 8°-31°). The average reduction was 18°. The average intermetatarsal angle showed mean reduction of 5.3° at the final follow-up. Average range of motion of the first metatarsophalyngeal joint preoperatively and at final follow-up showed a small reduction of 5 degrees. The average preoperative AOFAS score was 49, which improved by 35 points to 84 at the final follow-up. 11.42% of the patients in the study group had a recurrence. Conclusions. 1. Based on our experience with distal chevron osteotomy without lateral soft tissue release, we found the procedure easy to perform with good procedural outcomes. 2. The possible complications of lateral soft tissue release are avoided.

scholarly journals Outcomes of Scarf and Akin Osteotomy with Intra-Articular Stepwise Lateral Soft Tissue Release for Correcting Hallux Valgus Deformity in Rheumatoid Arthritis

2021 ◽  
Vol 18 (20) ◽  
pp. 10667
Author(s):  
Takumi Matsumoto ◽  
Yuji Maenohara ◽  
Song Ho Chang ◽  
Kumiko Ono ◽  
Yasunori Omata ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Soft Tissue ◽  
Hallux Valgus ◽  
Valgus Deformity ◽  
Soft Tissue Release ◽  
Intermetatarsal Angle ◽  
Hallux Valgus Deformity ◽  
Patient Reported ◽  
Akin Osteotomy

Background. The effectiveness of scarf and Akin osteotomy with intra-articular lateral soft tissue release for the correction of hallux valgus (HV) in patients with rheumatoid arthritis (RA) has not been elucidated. Methods. A total of 36 feet in 28 patients with RA who had scarf and Akin osteotomy with intra-articular stepwise lateral soft tissue release between 2015 and 2020 at a single institute were investigated retrospectively, with a mean follow-up period of 32.0 ± 16.9 months. Radiographic evaluations including the HV angle, intermetatarsal angle, and sesamoid position were performed preoperatively and postoperatively. Clinical outcomes were assessed using the Japanese Society of Surgery of the Foot (JSSF) hallux scale and self-administered foot evaluation questionnaire (SAFE-Q). Results. The procedure resulted in significant HV correction, with a recurrence rate of 13.9%. The JSSF scale and all five SAFE-Q subscale scores significantly improved (p < 0.05), with no major complications. More than 90% of cases achieved adequate lateral soft tissue release without sacrificing the adductor tendon of the hallux. Conclusions. Intra-articular stepwise lateral soft tissue release in combination with scarf and Akin osteotomy provided satisfactory radiographic and patient-reported outcomes for the correction of HV in patients with RA with minimum lateral soft tissue release.

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