Mark Glazebrook1. 1. Dalhousie University, Queen Elizabeth II Health Sciences Center Halifax Infirmary, Suite 4867, 1796 Summer Street, Halifax, NS B3H3A7, Canada.
Abstract
INTRODUCTION: Treatment of hallux valgus with an increased intermetatarsal angle (approximately 12° to 20°) involves surgical correction of the hallux valgus by performing a bunionectomy, lateral release, and proximal opening wedge osteotomy of the first metatarsal. STEP 1 BUNIONECTOMY: Perform a bunionectomy using a plantar and medial approach over the metatarsophalangeal joint. STEP 2 LATERAL METATARSOPHALANGEAL JOINT RELEASE: Release the contracted soft tissues lateral to the metatarsophalangeal joint to allow reduction of the noncongruent metatarsophalangeal joint using a 1 to 2-cm incision in the web space. STEP 3 PROXIMAL OPENING WEDGE OSTEOTOMY: Make the proximal opening wedge osteotomy through a dorsal medial incision. STEP 4 WOUND CLOSURE: Close the wounds using nylon sutures, and apply sterile dressings and a cast. STEP 5 POSTOPERATIVE COURSE: Patients are restricted to non-weight-bearing and then are progressed to full weight-bearing. RESULTS: Hallux valgus surgical correction, using a bunionectomy, lateral release, and a proximal opening wedge osteotomy, was performed for the treatment of hallux valgus with an increased intermetatarsal angle in a randomized controlled trial.IndicationsContraindicationsPitfalls & Challenges.
INTRODUCTION: Treatment of hallux valgus with an increased intermetatarsal angle (approximately 12° to 20°) involves surgical correction of the hallux valgus by performing a bunionectomy, lateral release, and proximal opening wedge osteotomy of the first metatarsal. STEP 1 BUNIONECTOMY: Perform a bunionectomy using a plantar and medial approach over the metatarsophalangeal joint. STEP 2 LATERAL METATARSOPHALANGEAL JOINT RELEASE: Release the contracted soft tissues lateral to the metatarsophalangeal joint to allow reduction of the noncongruent metatarsophalangeal joint using a 1 to 2-cm incision in the web space. STEP 3 PROXIMAL OPENING WEDGE OSTEOTOMY: Make the proximal opening wedge osteotomy through a dorsal medial incision. STEP 4 WOUND CLOSURE: Close the wounds using nylon sutures, and apply sterile dressings and a cast. STEP 5 POSTOPERATIVE COURSE: Patients are restricted to non-weight-bearing and then are progressed to full weight-bearing. RESULTS: Hallux valgus surgical correction, using a bunionectomy, lateral release, and a proximal opening wedge osteotomy, was performed for the treatment of hallux valgus with an increased intermetatarsal angle in a randomized controlled trial.IndicationsContraindicationsPitfalls & Challenges.
Authors: Mark Glazebrook; Peter Copithorne; Gordon Boyd; Timothy Daniels; Karl-André Lalonde; Patricia Francis; Michael Hickey Journal: J Bone Joint Surg Am Date: 2014-10-01 Impact factor: 5.284