Repair of hallux valgus with a distal soft-tissue procedure and proximal metatarsal osteotomy. A long-term follow-up.

1992 ◽  
Vol 74 (1) ◽  
pp. 124-129 ◽  
Author(s):  
R A Mann ◽  
S Rudicel ◽  
S C Graves
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Metatarsal Osteotomy ◽  
Soft Tissue Procedure ◽  
Long Term Follow Up ◽  
Proximal Metatarsal Osteotomy

Distal Soft Tissue Procedure and Proximal Metatarsal Osteotomy in Hallux Valgus

2000 ◽  
Vol 379 ◽  
pp. 209-217 ◽  
Author(s):  
Ryuzo Okuda ◽  
Mitsuo Kinoshita ◽  
Junichi Morikawa ◽  
Tsuyoshi Jotoku ◽  
Muneaki Abe
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Metatarsal Osteotomy ◽  
Soft Tissue Procedure ◽  
Proximal Metatarsal Osteotomy

Advanced Hallux Valgus Deformity: Long-Term Results Utilizing the Distal Soft Tissue Procedure and Proximal Metatarsal Osteotomy

1996 ◽  
Vol 17 (3) ◽  
pp. 142-144 ◽  
Author(s):  
Sharon Dreeben ◽  
Roger A. Mann
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Valgus Deformity ◽  
Metatarsal Osteotomy ◽  
Intermetatarsal Angle ◽  
Loss Of Correction ◽  
Hallux Valgus Deformity ◽  
Average Loss ◽  
Proximal Metatarsal Osteotomy

A series of 28 cases with a moderate to severe hallux valgus deformity and intermetatarsal angle of 14° or greater was followed an average of 5½ years to determine whether any significant loss of correction occurred. All feet were treated with a distal soft tissue procedure and proximal metatarsal osteotomy. The average correction of the intermetatarsal angle was 13.2° (7–20°), and the average loss of correction was 1.4°; the average correction of the hallux valgus angle was 26.7° (−2° to 48°), and the average loss of correction was 3.8°. In three cases, a recurrent deformity developed; in three other cases, a hallux varus deformity developed, two of which were symptomatic. Patient satisfaction was 85%. This study indicates that in most patients with a hallux valgus deformity and an intermetatarsal angle of 14° or greater, there is sufficient inherent stability of the first metatarsocuneiform joint that it does not require stabilization to obtain a satisfactory long-term result.

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.

scholarly journals Treatment of Hallux Valgus Deformity Using a Suture Button Device: A Preliminary Report

2018 ◽  
Vol 3 (4) ◽  
pp. 247301141880695
Author(s):  
Tyler A. Gonzalez ◽  
Jeremy T. Smith ◽  
Eric M. Bluman ◽  
Lauren V. Ready ◽  
William Ciurylo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Normal Position ◽  
Suture Button ◽  
Soft Tissue Procedure ◽  
Sf 36 ◽  
Second Metatarsal ◽  
Average Change ◽  
The Mean

Background: Hallux valgus (HV) is commonly treated with proximal or distal first metatarsal osteotomy. Despite good correction, these procedures have inherent risks such as malunion, nonunion, metatarsal shortening, loss of fixation, and avascular necrosis. Suture button fixation has been used for HV treatment. It avoids the risks of corrective osteotomies while maintaining reduction of the intermetatarsal angle (IMA). The goal of this study was to assess the radiographic and functional outcomes of patients undergoing HV correction with a distal soft tissue procedure and proximal suture button fixation. Methods: The authors retrospectively reviewed the charts and radiographs of 22 patients who had undergone HV correction using a distal soft tissue correction and proximal fixation with a miniature suture button device (Mini TightRope; Arthrex, Inc, Naples, FL). Mean follow-up was 27.7 months. The IMA, hallux valgus angle (HVA), and sesamoid station were measured on radiographs obtained preoperatively as well as in the immediate postoperative period and at final follow-up. Preoperative and postoperative Short Form-36 (SF-36) and Foot and Ankle Ability Measure (FAAM) scores were collected. Postoperative complications, and any additional operative procedures performed were also recorded. Results: The mean preoperative IMA and HVA were 16.9 and 32.6 degrees, respectively. The mean immediate postoperative IMA was 5.2 degrees ( P < .0001) and the mean HVA was 9.8 degrees ( P < .0001). At final follow-up, the mean IMA was 8.2 degrees ( P < .0001) and the mean HVA was 16.7 degrees ( P < .0001). The average change in HVA from preoperative to final follow-up was 16.0 degrees and the average change in IMA from preoperative to final follow-up was 8.6 degrees ( P < .0001). Sesamoid station assessment at the 2-week follow-up showed that 22 patients (100%) were in the normal position group; at final follow-up, 17 patients (77%) had normal position and 5 patients (23%) had displaced position. Although there were no clinically symptomatic recurrences, asymptomatic radiographic recurrence was noted in 5 patients (23%) who had a final HVA >20 degrees. All components of the FAAM and the SF-36 showed improvement from preoperative to final follow-up, although these changes were not statistically significant. Three patients experienced complications, including an intraoperative second metatarsal fracture, a postoperative second metatarsal stress fracture, and a postoperative deep vein thrombosis. Conclusion: The use of a distal soft tissue procedure in conjunction with proximal suture button fixation is a safe and effective procedure for treating symptomatic HV deformity. Our results show that this technique can correct the IMA, HVA, and sesamoid station without the need for osteotomy. Level of evidence: Level IV.

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