| Plantar loading after chevron osteotomy combined with postoperative physical therapy. | |
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MedLine Citation:
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PMID: 21189191 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Recent pedobarographic studies have demonstrated decreased loading of the great toe region and the first metatarsal head at a short- and intermediate-term followup. The purpose of the present study was to determine if a postoperative rehabilitation program helped to improve weightbearing of the first ray after chevron osteotomy for correction of hallux valgus deformity. MATERIALS AND METHODS: Twenty-nine patients with a mean age of 58 years with mild to moderate hallux valgus deformity who underwent a chevron osteotomy were included. Postoperatively, the patients received a multimodal rehabilitation program including mobilization, manual therapy, strengthening exercises and gait training. Preoperative and one year postoperative plantar pressure distribution parameters including maximum force, contact area and force-time integral were evaluated. Additionally the AOFAS score, ROM of the first MTP joint and plain radiographs were assessed. The results were compared using Student's t-test and level of significance was set at p < 0.05. RESULTS: In the great toe, the mean maximum force increased from 72.2 N preoperatively to 106.8 N 1 year after surgery. The mean contact area increased from 7.6 cm(2) preoperatively to 8.9 cm(2) 1 year after surgery and the mean force-time integral increased from 20.8 N(*)sec to 30.5 N(*)sec. All changes were statistically significant (p < 0.05). For the first metatarsal head region, the mean maximum force increased from 122.5 N preoperatively to 144.7 N one year after surgery and the mean force-time integral increased from 42.3 N(*)sec preoperatively to 52.6 N(*)sec 1 year postoperatively (p = 0.068 and p = 0.055, respectively). The mean AOFAS score increased from 61 points preoperatively to 94 points at final followup (p < 0.001). The average hallux valgus angle decreased from 31 degrees to 9 degrees and the average first intermetatarsal angle decreased from 14 degrees to 6 degrees (p < 0.001 for both). CONCLUSION: Our results suggest that postoperative physical therapy and gait training with a Chevron osteotomy may help to improve weightbearing of the great toe and first ray. Therefore, we believe there is a restoration of more physiological gait patterns in patients who receive this postoperative regimen. |
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Authors:
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Reinhard Schuh; Samuel Adams; Stefan Gerhard Hofstaetter; Martin Krismer; Hans-Joerg Trnka |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Foot & ankle international. / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society Volume: 31 ISSN: 1071-1007 ISO Abbreviation: Foot Ankle Int Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-12-29 Completed Date: 2011-01-20 Revised Date: 2013-02-25 |
Medline Journal Info:
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Nlm Unique ID: 9433869 Medline TA: Foot Ankle Int Country: United States |
Other Details:
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Languages: eng Pagination: 980-6 Citation Subset: IM |
Affiliation:
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Innsbruck Medical University, Department of Orthopaedic Surgery, Anichstrasse 35, Innsbruck, 6020, Austria. reinhard.schuh@uki.at |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Forefoot, Human / physiology* Gait Hallux / physiology* Hallux Valgus / physiopathology, surgery* Humans Male Middle Aged Osteotomy / methods, rehabilitation* Physical Therapy Modalities* Postoperative Care Pressure Prospective Studies Weight-Bearing / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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