Do Postoperative Hallux Angles Correlate With Outcome in MP1 Fusion? Our Experience With 71 Cases

2018 ◽  
Vol 11 (6) ◽  
pp. 500-506 ◽  
Author(s):  
Xavier Paredes-Carnero ◽  
Antonio María Fernández-Cebrián ◽  
Silvia Villardefrancos-Gil
Keyword(s):  
Clinical Outcomes ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Good Alternative ◽  
Hallux Rigidus ◽  
Hallux Valgus Angle ◽  
Aofas Score ◽  
Score Improvement ◽  
Valgus Angle ◽  
American Orthopaedic

Purpose: To determine if the postoperative alignment of the hallux influences the final clinical outcome of hallux metatarsophalangeal joint (first MTPJ) arthrodesis. Methods: A total of 71 consecutive cases (hallux rigidus) were studied in stages 3 and 4. They were operated through arthrodesis between 2008 and 2014. The follow-up mean was 7.3 years. The AOFAS (American Orthopaedic Foot and Ankle Society) test was performed preintervention and per annum. In radiology, both the hallux valgus angle and the dorsiflexion angle of the first MTPJ were studied. Furthermore, clinical outcomes were evaluated according to the type of implant used. Results: Preoperative AOFAS score was 27.5, rising to 91.3 after the intervention ( P < .01). The improvement test average was 63.6. There were 17 local complications (23%), 7 of them were considered to be major complications (9%), 6 of which needed reoperation (8.5%). The dorsiflexion angle postoperative mean was 21.7°. The hallux valgus angle postoperative mean was 10.9°. No correlations between both angles, and improved AOFAS score or complications ( P > .4 and P > .5, respectively), were found. Patients who had a dorsiflexion angle higher than 20° had greater improvement in the AOFAS score compared with those who had angles lower than 20° (64.5 vs 59.6 points). Nevertheless, this result was not statistically significant ( P = .059). No differences in AOFAS score improvement regarding arthrodesis plate ( P > .1) were found. Conclusion: First MTPJ arthrodesis is a good alternative for patients in advanced hallux rigidus stages when conservative treatment fails. We could not confirm if a better postoperative alignment may influence in clinical outcomes. However, better results are obtained with dorsiflexion angle greater than 20° than with those with less than 20°. Likewise, any differences between the 2 arthrodesis plates have been able to confirm. Levels of Evidence: Level III: Retrospective cohort study

Intermetatarsal Angular Change Following Fusion of the First Metatarsophalangeal Joint

2009 ◽  
Vol 30 (5) ◽  
pp. 415-418 ◽  
Author(s):  
K.V. Satya Pydah ◽  
Eugene M. Toh ◽  
Siva P. Sirikonda ◽  
Christopher R. Walker
Keyword(s):  
Hallux Valgus ◽  
Corrective Osteotomy ◽  
Metatarsophalangeal Joint ◽  
Hallux Valgus Angle ◽  
First Metatarsophalangeal Joint ◽  
Intermetatarsal Angle ◽  
First Metatarsal ◽  
Valgus Angle ◽  
Low Profile ◽  
American Orthopaedic

Background: Arthrodesis of the first metatarsophalangeal (MTP) joint with a low profile fixed angle plate allows for a consistent resultant hallux valgus angle. There is no clear consensus on whether a separate corrective osteotomy of the first metatarsal should be performed in addition to the first metatarsophalangeal joint fusion in patients with an increased intermetatarsal angle. We quantified the amount of correction of the intermetatarsal angle as well as the position of the tibial sesamoid in this group of patients following fusion of the first MTP joint. Materials and Methods: A consecutive cohort of 69 feet (13 bilateral) who underwent a standard primary fusion of the first metatarsophalangeal joint using a dorsal approach between May 2006 and January 2008 were reviewed. Radiological measurements were taken from 6-week postoperative weightbearing radiographs and included the hallux valgus angle, intermetatarsal angle as well as the position of the tibial sesamoid in accordance to the American Orthopaedic Foot and Ankle Society guidelines. Results: Postoperatively, there was an improvement in the hallux valgus angle from 33.0 degrees to 10.4 degrees ( p < 0.001). The mean intermetatarsal angle also improved from 13.1 degrees preoperatively to 8.6 postoperatively ( p < 0.001). The position of the tibial sesamoid generally improved by at least one grade (Spearman's r = 0.74). There was a strong correlation ( r = 0.77, p < 0.001) between the preoperative intermetatarsal angle and the postoperative intermetatarsal angle. Conclusion: Both the intermetatarsal angle and position of the tibial sesamoid reliably improved following arthrodesis of the first MTP joint, negating the need for a separate osteotomy of the first metatarsal.

Modified Austin Procedure for Correction of Hallux Valgus

1997 ◽  
Vol 18 (3) ◽  
pp. 119-127 ◽  
Author(s):  
Hans-Jörg Trnka ◽  
Alexander Zembsch ◽  
Hermann Wiesauer ◽  
Marc Hungerford ◽  
Martin Salzer ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Hallux Valgus Angle ◽  
First Metatarsophalangeal Joint ◽  
Intermetatarsal Angle ◽  
Soft Tissue Procedure ◽  
Valgus Angle

The Austin osteotomy is a widely accepted method for correction of mild and moderate hallux valgus. In view of publications by Kitaoka et al. in 1991 and by Mann and colleagues, a more radical lateral soft tissue procedure was added to the originally described procedure. From September 1992 to January 1994, 85 patients underwent an Austin osteotomy combined with a lateral soft tissue procedure to correct their hallux valgus deformities. Seventy-nine patients (94 feet) were available for follow-up. The average patient age at the time of the operation was 47.1 years, and the average follow-up was 16.2 months. The average preoperative intermetatarsal angle was 13.9°, and the average hallux valgus angle was 29.7°. After surgery, the feet were corrected to an average intermetatarsal angle of 5.8° and an average hallux valgus angle of 11.9°. Sesamoid position was corrected from 2.1 before surgery to 0.5 after surgery. The results were also graded according to the Hallux Metatarsophalangeal Interphalangeal Score, and the functional and cosmetic outcomes were graded by the patient. Dissection of the plantar transverse ligament and release of the lateral capsule repositioned the tibial sesamoid and restored the biomechanics around the first metatarsophalangeal joint. There was no increased incidence of avascular necrosis of the first metatarsal head compared with the original technique.

Correlation of Hallux Valgus Surgical Outcome With AOFAS Forefoot Score and Radiological Parameters

2005 ◽  
Vol 26 (2) ◽  
pp. 122-127 ◽  
Author(s):  
David Thordarson ◽  
Edward Ebramzadeh ◽  
Murali Moorthy ◽  
Jessica Lee ◽  
Sally Rudicel
Keyword(s):  
Lower Extremity ◽  
Physical Examination ◽  
Hallux Valgus ◽  
Hallux Valgus Angle ◽  
Lower Extremity Function ◽  
Aofas Score ◽  
Intermetatarsal Angle ◽  
Valgus Angle ◽  
Sf 36 ◽  
Type Of Surgery

Background: The purpose of the study was to evaluate the effect of three different types of hallux valgus surgeries on patient function using validated questionnaires and to correlate the results with radiographic and physical examinations. This study presents the 2-year followup data of a previous prospective outcome study. Methods: One hundred and ninety-six patients were enrolled in this study and completed a baseline AAOS Lower Limb Outcomes Data Collection Questionnaire. They completed the same form at 6, 12, and 24 months after having one of three types of hallux valgus surgeries (106 chevron osteotomies, 72 modified McBride procedures, and 18 modified Lapidus procedures). This questionnaire included the Short Form-36 Health Survey (SF-36) as well as questions relating to lower extremity function. Additionally, physicians were asked to complete preoperative and postoperative questionnaires on each patient that included radiographic and physical examination data and the type of surgery done. Completed outcome surveys and radiographic data were available on 196 patients, and physical examination scores were available to assign an AOFAS score in 111 patients at 24-month followup. A one-way comparison was done after stratifying the results for the type of surgery, preoperative hallux valgus angle and 1-2 intermetatarsal angle, postoperative hallux valgus angle and 1-2 intermetatarsal angle, and the change in the angles. Results: Four of the 10 SF-36 scores (physical function, role-physical, bodily pain, and role-emotional) for the combined data improved by more than five points. For the AAOS lower extremity function scores, physical health and pain (68.5 to 81.6), satisfaction with symptoms (1.8 to 3.6), global foot and ankle (77.6 to 93.4), and shoe comfort (29.0 to 58.7) scores all increased significantly. The AOFAS score increased from 52.6 to 85.5 ( p < 0.001). Surprisingly, when comparing mild-to-moderate to severe deformities preoperatively and postoperatively using the absolute magnitude of the angular change in the hallux valgus or intermetatarsal angles, similar improvement was noted in AOFAS, SF-36, and AAOS lower extremity scores. The magnitude of preoperative deformity, postoperative residual deformity, and magnitude of correction also did not significantly change the amount of improvement in any of these scores. No significant differences were noted in the outcome scores among the three different surgeries. Conclusion: Patients who had hallux valgus surgery had significant improvements in four of their SF-36 scores, four of five of AAOS lower extremity scores, and AOFAS scores. The degree of deformity, amount of correction, or type of operation did not influence outcome.

scholarly journals Intramedullary and Intra-Osseous Arthrodesis of the Hallux Metatarsophalangeal Joint

2016 ◽  
Vol 24 (3) ◽  
pp. 358-361 ◽  
Author(s):  
Efstathios Drampalos ◽  
Shen Hwa Vun ◽  
Irfan Fayyaz
Keyword(s):  
Patient Satisfaction ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Visual Analogue Score ◽  
Hallux Rigidus ◽  
Bone Union ◽  
Aofas Score ◽  
Non Union ◽  
Intramedullary Device ◽  
The Mean

Purpose To review the outcome of arthrodesis of the hallux metatarsophalangeal (MTP) joint in 23 patients. Methods Records of 9 men and 14 women aged 27 to 88 (mean, 57) years who underwent arthrodesis of the hallux MTP joint using an intramedullary device and an intra-osseous device were reviewed. Indications for surgery were severe hallux valgus (n=15), hallux rigidus (n=6) and rheumatoid arthritis (n=2). Outcome measures included visual analogue score (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, bone union, hallux valgus angle (HVA), dorsiflexion angle (DA), complications, revision, and patient satisfaction. Results The mean follow-up was 19 (range, 6–38) months. The mean AOFAS score improved from 29 to 75.4 (p<0.0001) and the mean VAS for pain improved from 8.1 to 2.4 (p<0.0001). 20 (86%) of the patients were satisfied with the outcome. The mean HVA was 14° and the mean DA was 22°. 19 (83%) of the toes had a well-aligned hallux. 21 (91%) of the patients achieved arthrodesis of the hallux MTP joint. The remaining 2 patients underwent revision surgery for failed fusion or infected non-union; they continued to have transfer metatarsalgia despite bone union. Conclusion The intramedullary and intra-osseous devices for arthrodesis of the hallux MTP joint achieved good outcome in terms of AOFAS score, VAS for pain, HVA, DA, bone union, and patient satisfaction.

scholarly journals Comparison of the clinical outcomes of Scarf and Chevron Osteotomy for Hallux Valgus Deformity: a meta-analysis of randomized controlled trial

2019 ◽  
Author(s):  
Wei Ye ◽  
Yafang Liu ◽  
WeiFeng Liu ◽  
XiaoLong Li ◽  
Yanqiang Fei ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Hallux Valgus ◽  
Meta Analysis ◽  
Valgus Deformity ◽  
Hallux Valgus Angle ◽  
Scarf Osteotomy ◽  
Randomized Controlled ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle

Abstract Background Scarf and Chevron Osteotomy have been widely used for Hallux Valgus Deformity(HVD) to correcting hallux valgus angle (HVA) and intermetatarsal 1-2 angle (IMA), but there still have controversy which approach is the best way to repair HVD,this study aims to use meta-analysis to evaluate the clinical outcomes of Scarf and Chevron Osteotomy for Hallux Valgus Deformity.Methods Pubmed, Embase, Medline and Cochrane library databases were searched for relevant studies published before September 1, 2019. Studies clearly reporting a comparison of Scarf and Chevron Osteotomy for Hallux Valgus Deformity were selected. The Post-operative hallux valgus angle (HVA) and intermetatarsal 1-2 angle (IMA) were evaluated and also the correction of HVA and IMA. The weighted mean differences and relative risks were calculated using a fixed-effects or random-effects model.Results Five studies were included in this meta-analysis,one were prospective randomized controlled trials and three were randomized control trials.A total of 434 patients (210 Scarf and 224 Chevron) were enrolled in the studies.Compare Scarf Osteotomy,Chevron Osteotomy can significantly decreaseed Post-operative hallux valgus angle (HVA)[MD = 1.92 95% CI (1.21 to 2.63),P < 0.0001],but there have no significantly difference between Scarf and Chevron Osteotomy groups in terms of Postoperative intermetatarsal angle (IMA),the correction of IMA and HVA(C-IMA/HVA),DMAA,AOFAS and complication incidence[MD = 0.42, 95% CI (-0.34 to 1.17),P=0.28;MD = -0.30, 95% CI (-0.72 to 0.12),P =0.16; MD = -0.88, 95% CI (-2.34 to 0.57),P =0.23;MD = -0.78, 95% CI (-2.29 to 0.72),P =0.31;MD = -2.01, 95% CI (-9.81 to 5.61),P =0.59 and OR=0.80, 95% CI (0.40 to 1.60),P=0.53 respectively].Conclusion Compare Scarf osteotomy,Chevron Osteotomy can significantly decreaseed Post-operative hallux valgus angle (HVA) and other clinical outcomes are similar between the two treatments.

Does Hallux Valgus Correction Reduce the Width of the Forefoot?

2019 ◽  
Vol 13 (2) ◽  
pp. 112-115 ◽  
Author(s):  
Vinod Panchbhavi ◽  
Justin Cordova ◽  
Jie Chen ◽  
Cory Janney
Keyword(s):  
Clinical Outcomes ◽  
Hallux Valgus ◽  
Surgical Procedures ◽  
Case Series ◽  
Hallux Valgus Angle ◽  
Linear Measurements ◽  
Levels Of Evidence ◽  
Chevron Osteotomy ◽  
Valgus Angle ◽  
Akin Osteotomy

Background: Hallux valgus has been associated with a widened forefoot. Most surgical procedures for the correction of hallux valgus have the potential to reduce forefoot width. Success after hallux valgus surgery is correlated with relief of toe pain in conventional shoes and improvement in the appearance of the foot. Therefore, reduction in forefoot width, referred to as metatarsal span (MS), likely correlates with both criteria and may be a reliable radiographic indicator of success after hallux valgus surgery. Methods: Preoperative and postoperative radiographs of 52 patients who underwent correction of hallux valgus with a distal Chevron osteotomy and Akin osteotomy were evaluated by 4 observers. The observers measured the hallux valgus angle (HVA), the intermetatarsal first and second angle (IMA), and the MS. Results: Preoperative HVA ranged from 14° to 48°, IMA ranged from 6° to 25°, and MS ranged from 74.2 to 110.6 mm. The average HVA improvement was 19.4°, IMA improvement was 6.7°, and MS reduction was 8.7 mm. No correlation was identified with regard to correction of the HVA or IMA to MS. Conclusion: Digital radiographic linear measurements were easily and reliably made. Therefore, linear measurements as described in this article can be used as a tool to evaluate if clinical outcomes correlate with reduction of MS. A distal Chevron with an Akin osteotomy has the potential to reduce forefoot width. Levels of Evidence: Level IV: Case series

scholarly journals The Influence of Patient Factors on the Outcome of Synthetic Cartilage Implant Hemiarthroplasty versus First Metatarsophalangeal Joint Arthrodesis

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Andrew Goldberg ◽  
Mark Glazebrook ◽  
Timothy Daniels ◽  
Gwyneth de Vries ◽  
M. Elizabeth Pedersen ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Clinical Success ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Success Rates ◽  
Preoperative Pain ◽  
Duration Of Symptoms ◽  
First Metatarsophalangeal Joint ◽  
Valgus Angle ◽  
The Impact

Category: Midfoot/Forefoot Introduction/Purpose: Many studies have compared the outcomes of MTPJ1 hemiarthroplasty and arthrodesis, but there is a paucity of data on the influence of patient factors on clinical outcomes. A prior prospective, randomized, clinical trial compared the efficacy and safety of first metatarsophalangeal joint (MTPJ1) hemiarthroplasty with a synthetic polyvinyl alcohol hydrogel implant (Cartiva®) and MTPJ1 arthrodesis for moderate to severe hallux rigidus. The current study evaluated the data from this clinical trial to determine the impact of numerous patient variables, including osteoarthritis grade, hallux valgus angle, preoperative range of motion (ROM), gender, body mass index (BMI), preoperative duration of symptoms, and preoperative pain level, on the success or failure of MTPJ1 hemiarthroplasty and arthrodesis. Methods: Patients =18 years diagnosed with hallux rigidus grade 2, 3, or 4 were randomized and treated with synthetic cartilage implant MTPJ1 hemiarthroplasty (n=129) or arthrodesis (n=47). Outcome measures included a pain visual analogue scale (VAS), Foot and Ankle Ability Measure (FAAM) Sports and Activities of Daily Living (ADL) scores, and Short Form-36 Physical Functioning (SF-36 PF) subscore, obtained preoperatively and at 2, 6, 12, 24, 52 and 104 weeks postoperatively. Great toe active dorsiflexion motion, secondary procedures, radiographs and safety parameters were evaluated. A patient’s outcome was deemed successful if composite primary endpoint criteria for clinical success (pain, function and safety) were met at 24 months. Predictor variables included: osteoarthritis grade; hallux valgus angle; preoperative ROM; gender; body mass index (BMI); preoperative symptom duration; prior surgery; and preoperative pain level. Two-sided Fisher’s Exact test was used to assess the impact of these variables on success of surgery (p<0.05). Results: Standard patient demographics and baseline outcome measures were similar for both groups; both procedures demonstrated equivalent pain relief and functional outcomes.1 There was no significant difference (p>0.05) in success rates (i.e., VAS pain reduction ≥ 30%, maintenance/improvement in function, freedom from radiographic complications, and no secondary surgical intervention) between synthetic cartilage implant MTPJ1 hemiarthroplasty and arthrodesis when stratified by osteoarthritis grade, degree of preoperative hallux valgus, extent of preoperative ROM, gender, BMI, duration of symptoms, prior MTPJ1 surgery status, and preoperative pain VAS score (Table 1). Notably, patients with minimal ROM and mild hallux valgus had equivalent success rates for both procedures. Males tended to have greater clinical success with implant hemiarthroplasty versus arthrodesis, but this difference was not statistically significant. 1Baumhauer et al., FAI, 2016;37(5):457-69. Conclusion: Synthetic cartilage implant hemiarthroplasty is an appropriate treatment for patients with hallux rigidus of Coughlin grade 2, 3 or 4. Its results in those with associated mild hallux valgus (<20 degrees) and in those with a high degree of preoperative stiffness are equivalent to MTPJ1 fusion, irrespective of gender, BMI, osteoarthritis grade, or preoperative pain or duration of symptoms, in contrast to what might have been expected.

scholarly journals Percutaneous Chevron Osteotomy Combined with Adductor Tendon Release for Hallux Valgus Correction

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0013
Author(s):  
Sofia Carlucci ◽  
Nelly Carrasco ◽  
Maria Santini-Araujo ◽  
Ana Parise ◽  
Leonardo Conti ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Deformity Correction ◽  
Hallux Valgus Angle ◽  
Chevron Osteotomy ◽  
Metatarsal Angle ◽  
Valgus Angle ◽  
Akin Osteotomy ◽  
American Orthopaedic

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: The use of minimally invasive techniques for hallux valgus may provide complete deformity correction with minor soft tissue damage, which reduces morbidity and shortens recovery. In this way, some open osteotomies were adapted to percutaneous approaches, with good outcomes reported. The minimally invasive chevron-Akin (MICA) described by Vernois and Redfern in 2011, combines benefits of percutaneous approaches with a stable internal fixation. Since 2015 we have adapted this technique, by adding a percutaneous adductor tenotomy to dispense with the Akin osteotomy. The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a minimally invasive chevron osteotomy and a percutaneous adductor tendon release. Methods: This was a prospective cohort study. A total of 38 feet with moderate hallux valgus underwent the procedure and were followed up for a minimum 12 months (SD 1.10). The median age was 58 years (IQR 52 - 65), 36 women and 2 men. Radiological parameters were compared at preoperatory and at the last follow-up and included: Hallux Valgus Angle (HVA), Inter- Metatarsal Angle (IMA), Distal Metatarsal Articular Angle (DMAA) and first metatarsal shortening. Time to consolidation was also assessed. For clinical evaluation the American Orthopaedic Foot & Ankle Society score (AOFAS) was evaluated. Complications during the follow up were reported. Patients in which another procedure in the hallux was performed, with previous surgeries or not completed 1 year follow-up were excluded. Results: Radiologic postoperative parameters demonstrated to achieved correction. At the last follow up there was a statistically significant decrease in the hallux valgus angle, the intermetatarsal angle and distal metatarsal articular angle. Shortening of the first metatarsus was a mean 7.02 mm (IQR 1.24 - 10,27). The mean AOFAS score increased from 58.23 (SD 9.02) pre-operatively to 97.15 (SD 4.72) post-operatively (p< 0.001). Complications reported were 2 superficial infections, 1 broken screw, 1 screw extraction. Five patients referred metatarsalgia after surgery and 1 presented a fourth metatarsal stress fracture. Only one patient presented lost of correction in the first postoperative week and needed a second surgery. Conclusion: Our series of hallux valgus correction with a minimally invasive chevron osteotomy combined with the adductor tendon release shows good clinical and radiological outcomes, and results are comparable to series with the additional Akin osteotomy. Comparative studies are needed for major evidence.

scholarly journals First metatarsophalangeal arthrodesis for treatment of hallux valgus with metatarsus adductus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0054
Author(s):  
Yuan Zhu
Keyword(s):  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Visual Analog Scale Score ◽  
Dorsal Plate ◽  
Intermetatarsal Angle ◽  
Valgus Angle ◽  
Metatarsus Adductus ◽  
American Orthopaedic ◽  
Metatarsophalangeal Joints

Category: Bunion Introduction/Purpose: The surgical treatment of hallux valgus with severe metatarsus adductus deformity can be challenging. This study aims to investigate the clinical and radiologic outcomes of first metatarsophalangeal arthrodesis in treating this complex deformity. Methods: Between Jun 2009 and Jun 2015, 15 consecutive cases of hallux valgus with severe metatarsus adductus [metatarsus adductus angle, MAA>25°(modified Sgarlato method)] received first metatarsophalangeal arthrodesis for correction with a dorsal plate and a lag screw. The clinical outcome of these patients (average age of 63.1 years) was evaluated by means of the American Orthopaedic Foot & Ankle Society (AOFAS) Hallux MTP-IP Scale and ankle pain on the visual analogue scale (VAS). Radiological imaging included hallux valgus angle (HVA) and 1st intermetatarsal angle (IMA). Results: All these 15 patients were available for follow-up at a mean of 12.7 months. The average postoperative AOFAS Hallux MTP-IP Scale 12 months after surgery was 88.6 (compare with 60.8 preoperatively). The mean visual analog scale score decreased from 5.51 ± 1.53 preoperatively to 0.98 ± 0.98 at the latest follow-up. All the metatarsophalangeal joints got complete fused without delayed fusion. The HVA improved from 45.2°preoperatively in average to 17.3°postoperatively. No deformity recurrence was observed by the time of the latest follow-up. Conclusion: First metatarsophalangeal arthrodesis is a simple, reasonable and reliable option for the treatment of hallux valgus with severe metatarsus adductus deformity, especially for elderly patients with degenerated symptomatic metatarsophalangeal joint.

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