Document Detail


Proximal opening-wedge osteotomy of the first metatarsal for hallux valgus using a low profile plate.
MedLine Citation:
PMID:  19796591     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This retrospective study was conducted to evaluate the results of the proximal (basal) opening-wedge osteotomy of the first metatarsal for correction of symptomatic hallux valgus deformity, using a low profile plate.
MATERIALS AND METHOD: The procedure was performed by a single surgeon over an 18-month period. Forty-six patients (64 feet) were treated for symptomatic hallux valgus with an average follow up of 20 months. A proximal opening-wedge osteotomy of the first metatarsal and fixation with a low profile plate in combination with a distal soft tissue release with the same postoperative protocol was used in all the patients. Improvement in the hallux valgus angle (HV) and I---II intermetatarsal angle (IM I---II) as well as the AOFAS forefoot score pre and postoperatively (obtained retrospectively from the medical records), were recorded; in particular, the length of the first metatarsal was noted pre- and postoperatively.
RESULTS: The HV and IM I---II angles improved by a mean of 14.7 degrees and 6.4 degrees, respectively. The AOFAS forefoot score improved from a mean of 51.3 to 86.8. The mean increase in the length of the first metatarsal was 2.3 mm. Of the more significant complications, five patients developed a hallux varus (early in the series), one of which was symptomatic, and there was one non-union requiring bone graft.
CONCLUSION: The proximal opening wedge osteotomy of the first metatarsal in combination with a distal soft tissue release and stable fixation of the low profile plate was an effective method for correcting a moderate hallux valgus deformity. Guidance provided by the "First Metatarsal Opening Wedge Angle Reference Chart'' was found to be helpful for the IM I-II angle correction.
Authors:
Nikiforos P Saragas
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Foot & ankle international. / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society     Volume:  30     ISSN:  1071-1007     ISO Abbreviation:  Foot Ankle Int     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-02     Completed Date:  2009-12-03     Revised Date:  2013-02-25    
Medline Journal Info:
Nlm Unique ID:  9433869     Medline TA:  Foot Ankle Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  976-80     Citation Subset:  IM    
Affiliation:
Linksfield Park Clinic & University of the Witwatersrand, Orthopaedic Surgery, P.O. Box 1153, Highlands North, Johannesburg, Gauteng 2037, South Africa. saragas@global.co.za
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Bone Plates*
Female
Follow-Up Studies
Hallux Valgus / radiography,  surgery*
Humans
Male
Metatarsal Bones / radiography,  surgery*
Middle Aged
Osteotomy / methods*
Postoperative Complications
Retrospective Studies
Tibia / transplantation
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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