Nuno M Corte-Real1, Rodrigo M Moreira. 1. Hopital de Saint Louis-Hospital de Curry Cabral, Orthopaedic Surgery, Rua da Beneficência 8, Lisboa 1500-461 Lisboa, Portugal. nc-r@netcabo.pt
Abstract
BACKGROUND: The surgical treatment of hallux valgus with an increased distal metatarsal articular angle (DMAA) should include the correction of this angle to maintain a congruent joint. The purpose of this study was to report our results with this procedure. MATERIALS AND METHODS: From January 2000 until December 2006, 23 feet (13 patients) with an increased DMAA were operated upon by the same surgeon using a biplanar chevron osteotomy. The technique was modified making the plantar cut more horizontal and only removing a wedge from the dorsal cut. Clinical and radiographic evaluation was made after a mean followup of 56 months. The AOFAS score for the hallux was used and angular deformities were measured. The patients had a mean age of 51 years and were all female. RESULTS: A good functional result was achieved with a mean AOFAS score of 87. An improvement of the angular deformities was noted in all patients. The mean hallux valgus angle improved from 28 degrees pre-op to 14 degrees post-op, the intermetatarsal angle from 12 degrees to 7 degrees and the DMAA from 20 degrees to 7 degrees. All patients except one were satisfied with the outcome of the procedure. Minimally symptomatic AVN of the metatarsal head was observed in one foot. CONCLUSIONS: We conclude that this procedure is a good choice for the treatment of symptomatic hallux valgus with an increased DMAA, producing a good clinical and radiographic result.
BACKGROUND: The surgical treatment of hallux valgus with an increased distal metatarsal articular angle (DMAA) should include the correction of this angle to maintain a congruent joint. The purpose of this study was to report our results with this procedure. MATERIALS AND METHODS: From January 2000 until December 2006, 23 feet (13 patients) with an increased DMAA were operated upon by the same surgeon using a biplanar chevron osteotomy. The technique was modified making the plantar cut more horizontal and only removing a wedge from the dorsal cut. Clinical and radiographic evaluation was made after a mean followup of 56 months. The AOFAS score for the hallux was used and angular deformities were measured. The patients had a mean age of 51 years and were all female. RESULTS: A good functional result was achieved with a mean AOFAS score of 87. An improvement of the angular deformities was noted in all patients. The mean hallux valgus angle improved from 28 degrees pre-op to 14 degrees post-op, the intermetatarsal angle from 12 degrees to 7 degrees and the DMAA from 20 degrees to 7 degrees. All patients except one were satisfied with the outcome of the procedure. Minimally symptomatic AVN of the metatarsal head was observed in one foot. CONCLUSIONS: We conclude that this procedure is a good choice for the treatment of symptomatic hallux valgus with an increased DMAA, producing a good clinical and radiographic result.