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Objective To evaluate efficacy,safety and complication of percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) in≥90 years patients.Methods Clinical data of 56 cases aged ≥ 90 years with osteoporotic vertebral compression fracture undergoing percutaneous kyphoplasty were retrospectively analyzed.Visual analog scale (VAS) score,analgesics administration score,locomotor activity score,bone cement leakage and incidence of refracture were evaluated before and 3 days after treatment,and at the last follow-up.Results The mean follow-up was 18.6 months (6-32 months) in all patients.The mean VAS score was (7.1 ±2.1) before treatment,(2.6±1.1) at 3 days after the procedure,and (1.8±0.7) at last follow-up,respectively (F=455.794,P＜0.001).Analgesics administration score were (2.0±1.7),(1.4±0.5) and (1.1±0.7) respectively before and 3 days after treatment,and at the last follow-up (F=9.631,P＜0.001).Locomotor activity score were (2.5±0.6),(1.2±0.5) and (1.0±0.3)before and 3 days after treatment,and at the last follow-up (F=63.254,P＜ 0.001) respectively.Bone cement leakage occurred in 10 cases(17.9％),recurrent fracture in 6 cases(10.7％),cerebrospinal leak in 3 cases (5.3％),and nerve root stimulation in2 cases(3.6％).Total complication rate was 33.9％(19/56),and all complications were transient and well tolerated.Conclusions Kyphoplasty for osteoporotic vertebral compression fracture in the very elderly is effective and safe.It alleviates fracture-induced pain,reduces analgesic drug use and improves spinal activity,and provides a better choice for minimal invasive treatment for nonagenarian OVCF patients.
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Objective To study the effects of glucosamine sulfate on nitric oxide(NO)production induced by interleukin(IL)-1β in human osteoarthritis chondrocytes(HOC),and explore the possible mechanism.Methods Chondrocytes were harvested from 10 osteoarthritis patients undergoing total knee replacement(TKR)operation.Human recombinant IL-1β(5 μg/L)and glucosamine sulfate GS in different concentrations(0.2 mmol/L,2.0 mmol/L,20.0 mmol/L)were administrated into cell culture medium for 24 h.The content of NO was detected by enzyme-linked immunosorbent assay(ELISA).The mRNA and protein expression of inductive nitric oxide synthetase(iNOS)were measured by RT-PCR and Western blot,respectively.Results Stimulation of HOC with IL-1β enhanced production of NO and expressions of iNOS mRNA and protein(t=-14.81,-45.38,all P＜0.01).Pretreatment with 2.0 and 20.0 mmol/L GS showed a dose-dependent inhibition of IL-1β induced NO production(F=12.43,P＜0.05)and the expression levels ofiNOSmRNA(F=142.28,P＜0.05)and protein(F=78.08,P＜0.01).20.0 mmol/L GS alone did not influence NO production(t =-0.17,P＞ 0.05).Conclusions GS may inhibit the synthesis of NO induced by IL-1β in HOC through down-regulate mRNA and protein expressions of iNOS.
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Objective To investigate the treatment effect of the proximal humeral internal locking system (PHIL()S) on the elderly patients with displaced proximal humeral fractures.MethodsFrom Feb 2004 to Mar 2007, 36 patients (mean age: 72.2 years) with proximal humeral fractures were treated with PHILOS plate fixation which included 14 cases with 2-part, 17 cases with three-part and 5 cases with four-part fractures according to Neer classification.Operation time,intraoperative blood loss, blood transfusion, perioperative complications and function evaluation of the operated shoulder joint were calculated with 14.5 months follow-up at average.Results The average operation time and blood loss were (61.5± 11.6) min and ( 165.2±91.2) ml, respectively. 1 case with accidents of blood vessel and 1 case with pneumonia were found without neurovascular injuries. All fractures were radiographically healed in an average of 3-5 months.No necrosis of humeral head appeared and 30 (83.3％) cases were excellent or good according to Neer scoring system. Two part fracture and early operation ( within 3 days after operation) might improve the postoperative function of shoulder joint, but the patient's age, gender and ASA score were not statistically with Neer score.Conclusions PHILOS plate fixation is a suitable procedure for displaced proximal humeral fractures via stable fixation and early rehabilitation, especially for elderly patients combined with osteoporosis.
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Objective To evaluate the result of open rotator cuff repair and to identify potential preoperative or intraoperative factors that could affect the outcome.Methods 43 cases(44 shoulders)with rotator cuff tear who undergone open repair surgery between May 1987 and October 2002 were retrospectively studied.There were 31 shoulders ruptured in supraspinatus, 9 shoulders in supraspinatus and infraspinatus,3 shoulders in supraspinatus and subscapulafis and 1 in supraspinatus, infraspinatus and subscapularis.And there were 13 shoulders torn with small size, 18 shoulders with middle size, 10 shoulders with large size and 3 shoulders with massive size.Ruptured rotator cuff was repaired with tendon to bone suture in 25 shoulders,with tendon to tendon suture in 7 shoulders, and combined suture in 11 shoulders.One shoulder was repaired by deltoid transfer.After an average 88.2-month-long follow-up(from 52 to 250 months),we evaluate the postoperative shoulder function with University of California at Los Angeles(UCLA)score.The patient's subject satisfaction was assayed by visual analogue scale (VAS).The risk factors as age, sex,dominant side, trauma history,preoperative duration and tear size were analyzed.Results The average UCLA score was 11.5±2.8 preoperatively and 29.7±5.3 at follow-up, with 36 shoulders reaching excellent or good and 2 shoulders ranking poor.According to VAS,the subject satisfaction rate was as high as 89%,being positively related to UCLA score significantly(r=0.72,P＜0.01).Preoperative duration(r=-0.332,P=0.028)and tear size(r=-0.404,P=-0.007)was negatively relative with surgical results.Age,sex,dominant side,trauma history had no effect on prognosis.Conclusion Open rotator cuff repair could acquire satisfying outcome.Preoperative duration and tear size was negatively relative with surgical results.
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Objective To observe the pathologic type and degree of traumatic recurrent anterior dislocation of the shoulder by means of arthroscopy and discuss clinical results of modified Bristow method and arthroscopic Bankart reconstruction so as to provide refeFences for selecting operation methods.Methods A retrospective study was done off 62 patients(62 shoulders,44 males and 18 females.at av-erage age of 39.8 years.ranging from 21 to 67 years)with anterior recurrent dislocation of shoulder (mean duration of 87 months)admitted into our hospital from July 1997 to Oetcher 2007.All patients un-derwent preoperative arthroscopic examination that showed pathologic changes including injury of shoulder and humerus head,Bankart injury severity and laxitas of humerus glenoid ligament of articular capsule,which were used as referenee of surgical procedures.Modified Bristow's method or arthroscopic suture anchor Bankart reconstruction were performed according to arthroscopic results(pathologic change).The patients were assessed with the University of California at Los Angeles(UCLA)shoulder rating scale.Results There were 45 patients treated with modified Bristow,s method and 17 with arthroscopic suture anchor Bankart reconstruction.The follow.uD for mean 64.2 months showed that pre-and post-operative mean UCLA scores were(22.6±4.4)points and(29.8±4.2)points respectively(P＜0.01),the mean forward flexion(136.8±14.2)°and(156.6±17.8)°respectively(P＜0.01)and the mean ex-ternal rotation in 90°abduction(52.5±16.4)°and(72.4±11.3)°(P＜0.01).There were no redis-location at final follow-up,but there were 6 patients(9.6%)with positive apprehension test.Of all,60 patients(97%)returned to their pre-injury.work. Conclusions Observation of pathologic change of surgical procedure.Both modified Bristow's method and arthruscopic Bankart reconstruction are good methtxts for treatment of recurrent anterior shoulder dislocation under conditions of successful management of pathologic change of shoulder, restoration of normal anatomic structure of shoulder ioint and strict indi-cation control.
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ObjectiveTo analyze therapeutic effects of conservative treatment and the causes of malunion of intertrochanteric fracture in elderly patients, and try to find the way to deal with the problems. MethodsFifteen cases aged 75 to 101 years with intertroehanterie fracture treated conservatively were included.Their average age was 88.8 years.All fractures were classified according to Evens-Jensen.Because of the medical complication or other reasons, they were conservatively treated by methods of traction, wearing shoes et al. X-ray examination was taken at regular time and their final functions were assessed. ResultsTwo cases were died 1-3 months after admission, and the fractures were only partially healed. The remaining thirteen cases got complete healing. Among the fifteen cases, the deformity did not happen in 4 cases of IA without fixation and 1 case of IIB with bone traction. All others got the deformity of varus, shorting and external rotation in different degree, which interfered the lower extremity motor function. ConclusionsThe fracture position not kept and fixed satisfactorily during treatment would lead to more joint deformity and deteriorated hip joint function for the displaced intertroehanterie fractures in elderly patients.
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ObjectiveTo investigate the effects of raloxifene on osteoprotegerin (OPG)/receptor activator nuclear factor kappa B ligand (RANKL) expression in mouse osteoblasts.MethodsSterile calvaria of mouse was taken from 30 newborn mice, and the osteoblasts were separated by enzyme digestion methods. Raloxifene in different concentrations (0,10<'-12>, 10<'-10>, 10<'-9>mol/L) were administrated into culture medium. The OPG/RANKL mRNA expression and OPG protein secretion were examined by RT-PCR and ELISA methods respectively.ResultsOPG mRNA expression in osteoblasts after raloxifene treatment was significantly higher than that in control group(P<0.05), and compared to 10<'-9> mol/L and 10<'-12> mol/L groups, it was significantly increased in 10<'-10> mol/L group.RANKL mRNA expression in osteoblasts after raloxifene treatment was significantly lower than that in control group(P<0.01), and the effect showed a dose- dependent manner. Compared to the control group, OPG protein secretion of osteoblasts was promoted by raloxifene treatment (10<'-9> mol/L:3.017±0.459;10<'-10> mol/L: 3. 981±0.762;10<'-12> mol/L : 2.864±0.416; control: 2.106±0.316, P<0.05).ConclusionsRaloxifene can increase OPG mRNA expression, promote OPG protein secretion and inhibit RANKL mRNA expression in osteoblasts.
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BACKGROUND: Peak bone mass and standard deviation (SD) in different regions are varied, which have great influence on diagnosis of osteoporosis. To establish a complete database can provide accurate evidence for osteoporosis diagnosis. OBJECTIVE: To investigate the influence of bone mineral densities (BMD) and their SD of young people on the detective rate of osteoporosis in general population. DESIGN, TIME AND SETTING: Investigation analysis was performed at Beijing, Shanghai, Guangzhou, Nanjing, Jiaxing and Chengdu between January 1997 and December 1999. PARTICIPANTS: 11418 subjects from related 6 centers of BMD reference database in China were investigated and analyzed using prospective and retrospective methods, including 3 666 males, and 7 752 females aged 20-90 years. Of them, 2385 were from Beijing, 1178 from Guangzhou, 1404 from Shanghai, 2938 from Nanjing, 1425 from Chengdu, and 2088 from Jiaxing. The subjects were selected from community investigation, physical examination volunteers. METHODS: BMD of the lumbar spine (L2-4) and the hip in 11, 418 subjects from the related 6 centers in China was measured with GE-Lunar dual energy X-ray absorptiometry (DXA) and the BMD reference database was established. The accuracy rate of the inner machine was 0.3%-0.7%, and the accuracy of different machines averaged 1.1%. MAIN OUTCOME MEASURES: Lumbar BMD distribution of different age groups from 6 centers; influence of young people's BMD and its SD on detective rate of osteoporosis. RESULTS: Different BMD and SD were found in the individual subject from 6 centers, and the maximum differences were 0.098 g/cm2 and 0.027 g/cm2. With mean BMD and SD of the individuals from 6 centers as references, different T-scores and the detective rates of osteoporosis derived from the T-scores were found in the same group. The detective rate increased by 1.6% when BMD of the young people increased by 0.01 g/cm2 (positive correlation), but the detective rate decreased by 4% when SD increased by 0.01g/cm2 (negative correlation). CONCLUSION: Changes in BMD and SD of the young people can influence the detective rate of osteoporosis. To achieve comparability for the detective rate of osteoporosis in different centers, the specific reference database should be established for the same race, the same area, and the same bone densitometry machine. The T-score should be determined with the normal BMD and SD of the young, people as the reference database.
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Bone fracture is the most serious outcome of osteoporosis,the morbidity has been linked to age,gender and races.The characteristics of osteoporotic fracture include reduced bone quality,a delay in bone fracture union process,and a high incidence of re-fracture.The therapy of osteoporotic fracture includes surgical management and osteoporosis treatment.Osteoporosis treatment can improve bone quantity and bone quality,decrease the rate of fracture.The rule of surgical management is simpleness,safety,and efficacy.Because of poor bone quality,internal fixation and implant are easy lossened.Ideas for future research,such as development of a new implant with rigidity and elasticity like bone tissue,development of a new drug which can improve bone mass and quality quickly.Regardless of surgical management for osteoporotic fracture,pharmacological treatment of osteoporosis is also necessary.In order to get a good outcome of osteoporotic fracture treatment,both surgical management and osteoporosis treatment are important.
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Objective To enhance understanding of the vertebral compressed fracture in old patients so as to reduce its misdiagnosis. Methods 30 aged patients with vertebral compressed fracture were treated from 1998 to 2004 in our department. Their clinic data were retrospectively analyzed. There were 27 males and 3 females, aged from 70 to 90 years (averaging 82.5 years). Results All the patients were diagnosed definitely. There were 2 cases of T11 fracture, 13 cases of T12 fracture, 11 cases of L1 fracture, 3cases of L2 fracture, and 1 case of L3 fracture. At first 1 case was overlooked, and segmental positioning was wrong in 3 cases but the mistakes were corrected later. Conclusion Meticulous review of the history and clinical manifestation in addition to supplemental imageological examination are essential to early diagnosis of the majority of vertebral compressed fractures. As for some difficult early diagnoses, fat suppression MRI and nuclide bone scanning are helpful.
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This issue of CJOT features geriatric fractures, involving surgical treatment of intertrochanteric femoral fracture, proximal humeral fracture, distal radial fracture, and fractures of distal femur, patella, tibial shaft, and ankle. Osteoporosis is not only a common high risk factor for fractures in the aged population but also a leading cause for most of the postoperative problems. Besides osteoporosis, the complications common to the aged people add to the difficulty of the treatment of the geriatric fractures. As a result, how to improve the clinical effects and prevent refractures for old patients has become the chief concern in the treatment of geriatric fractures.
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Objective To evaluate the surgical results of spinal stenosis in the elderly and to investigate the indications , surgical technique and factors which may contribute to the outcome. Methods A retrospective study was held, 304 patients aged 65 and over who had different kinds of decompression laminectomy for lumbar spinal stenosis between Jan 1990 and Jun 2005 were recruited. The mean patient age at surgery was 70.4 years (65-86 years old). Results One hundred and seventy-five cases had co-existing illnesses, 62 had concomitant degenerative spondylolisthesis, 138 had spinal instrumentation. Functional results were graded as excellent, good, fair and poor: 86. 8% excellent or good, 11. 2% fair and 6 cases poor. Four patients had re-operations because of post operation hematomas. Multivariate analysis revealed that age, sex, co-morbidity score, number of levels decompressed, and degenerative spondylolisthesis did not predict bad outcomes. Conclusions The surgical results of spinal stenosis in the elderly are favourable and comparable to those reported for the general population . Carefully perioperative preparation is very important in the treatment of elderly patient with lumbar spinal stenosis.
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As the structure of shoulder joint is complex, proper method s should be adopted to treat the injured shoulder joint according to the type an d position of the trauma. Conservative treatment has been widely used to treat t he slightly displaced or stable fractures (including those of the proximal humer us, clavicle and shoulder blade), and most of the fresh dislocations of shoulder joint and acromioclavicular joint if the injuries are not serious. As for the o bvious unstable shoulder fractures, recurrent dislocation of shoulder joint, sev ere dislocation of acromioclavicular joint, dislocation of shoulder joint accomp anied with fracture, and rotator cuff tear, an operation should usually be the r ight choice. In either conservative or operative treatment, earlier systematic f unctional rehabilitation should be widely used in order to achieve satisfactory functional recovery of should joint.
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Objective To observe the BMD threshold of hip fracture in the elderly, analyze the pre-imposing factors leading to femoral neck fracture or intertrochanteric fracture, and provide some evidences for fracture prevention. Methods The BMD examination were performed on 496 fractured patients over 60 years old which were grouped after admission according to their age, gender and fracture types, and then the results were statistically analyzed. Results The BMD of fracture cases in the elderly over 60 years old was 2.5 s less than peak bone volume. There is no obvious difference in BMD between femoral neck fracture and intertrochanteric fracture among various age groups. According to our study, most hip fractures happened at the age of 60-79 years, accounting for 73%of all hip fractures. Conclusions Decreased bone mass or osteoporosis is an important factor leading to hip fracture in the elderly. The fracture types (femoral neck fracture or intertrochanteric fracture) depend mainly on the impaction force to the hip, not only on the BMD change.
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Objective To investigate the effects of absorbable gelatin sponge, chitosan and sodium hyaluronate(HA) on inhibition of postoperatively epidural scar formation in animal models with posterior discectomy and the concentrations of HA in the cerebral spinal fluid was also determined. Methods 96 Wistar rats older than 12 months were equally allocated into four groups. Each animal underwent a unilateral hemi-laminectomy and discectomy. Absorbable gelatin sponge, chitosan and HA were placed at the sites of surgery in three groups respectively. The fourth group undergone laminectomy and discectomy only, was served as control. At the time of 2,4, 8, 12 weeks postoperatively, 6 rats in each group were sacrificed for gross evaluation, histology and transmission electron microscope studies. The areas of epidural scar and spinal canal were measured by a computer image processor, and were compared statistically. The concentrations of HA in the cerebral spinal fluid in the HA groups and control groups were tested. Results The epidural scar areas in the chitosan and HA groups were significantly less than those in the control and absorbable gelatin sponge groups; no significant difference was found among the spinal canal areas of all the groups at different time phase; the compression and dislocation of the dura and spinal nerve roots and the discontinuity of the annulus fiber were observed in every group and time phase. The two cases with highest concentrations of HA were in the HA group at 2-week. Conclusion Chitosan and HA are able to inhibit the epidural scar formation after posterior discectomy. The healing of the annulus must be considered when evaluating the scar inhibition effects of materials. When the materials are placed in the epidural space, their effects on the central nervous system should be considered.
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Objective To analyse the treatment results of proximal humerus fracture in over sixty-years-old patients. Methods From January 1999 to January 2003, 32 cases suffered from fractures of the proximal humerus were studied, which involved 13 males (mean age 73.2 years, range 60-88 years), and 19 females (mean age 75.5 years, range 60-94 years). There were 22 cases (65.7%) with two-part fractures, among them, 68.1% was surgical neck fracture. 3 cases with two-part and 1 with three-part fracture were treated conservatively because of either their poor health condition or their refusal to operation. The other 28 patients were operated. According to the Neer classification, through the statistic and analysis for the method and outcome, all the cases were evaluated in term of the American UCLA scale system. Results 25 of the 28 operated patients were available at the final follow-up, the mean period was 1.5 years with a range of 1 to 3 years. All the fractures had united. 5 patients with healing time more than 3 months were those fractures classified as three or four-part, which needed the tension-band fixation. All the patients complained with joint stiffness in different degree, 6 of the patients with three or four-part remained with sustaining shoulder contracture. According to the UCLA, the good-excellent rate was 81.2% in the two-part fractures, and only 33.3% in the three or four-part fractures. Conclusion The treatment methods of proximal humerus fracture in aged patients should be selected according to individual condition. The tension band fixation is a good choice for those who can't accept the joint replacement, though the outcome after the four-part fractures fixation is less satisfactory. Joint contracture and humeral head necrosis may be the common complications among the patients rated as three or four-part fractures. After operation, early and complete rehabilitation are closely related to the treatment results.
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Objective To observe the reparative response and expression of basic fibroblast growth factor (bFGF) protein in the rotator cuff subjected to subacromial impingement. Methods Subacromial impingement of the infraspinatus tendon was experimentally created in 50 male SD rats by thickening the undersurface of the acromion with one platelike bony transplantation of the ipsilateral scapular spine. The contralateral shoulders that had undergone a sham operation were used as controls. The rats were sacrificed at 3, 7, 14, 28, and 56 th day, the whole shoulder joint was removed for detecting bFGF protein and the reparative response in the impinged infraspinatus tendon. Computer image analysis system were used to monitor the expression intensity and numbers of positive cells of bFGF protein. The OD scores and the size of area represent the expression intensity and numbers of positive cells respectively. Results All rats with experimental subacromial impingement showed an infraspinatus tear on the bursal side of the tendon. The shoulders in the control group were found intact without any alteration. There was proliferating cells in the fragmented tendons and vascularised connective tissue covering the area of ruptured area, whose source was the subacromial bursa. Few tenocytes and bursal cells expressed bFGF protein in unwounded tendons. In contrast, tendons subjected to impingement exhibited an increased signal for bFGF protein in both resident tenocytes concentrated along the epitenon and infiltrating fibroblasts and inflammatory cells from the subacromial bursa. Conclusion The bFGF protein is upregulated during tendon healing and the subacromial bursa is the main source of both bFGF secreting and rotator cuff repair; one should preserve as much as possible the subacromial bursa.
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Objective To evaluate the T lymphocyte functions in elderly patients following major orthopedic operation. Methods From May 1998 to Feb 1999, 39 elderly patients (65 95 years old) hospitalized for orthopedic operation were studied. The patients' peripheral blood samples in the experimental group were obtained on days 1, 3, 7 and 14 postoperation, respectively. At the same days, blood samples were taken from 15 elder patients without trauma and operation (65 80 years old) within 6 months as controls. T lymphocyte subpopulations were differentiated by means of quantitative assay with autocounting method of FCM. Results CD3 T cell count was significantly decreased on day 1(54 4?11 3)% and day 14(58 5?12 6)%, compared with controls (63 9?8 3)% ( P
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Objective To determine the sensitivity and accuracy of CT do ub le-contrast arthrography (CTA) in detecting underlying soft-tissue and bony abno rmalities of recurrent anterior glenohumeral dislocations. Methods From March 19 90 to May 2003, 31 patients with the signs and symptoms of recurrent anterior in stability, which were 23 males and 8 females with an average age of 26.7 years ( ranging, 22 to 46 years), were recruited for the study. All patients suffered fr om more than three times of glenohumeral dislocations, underwent CT arthrography after intraarticular injection of air and radiographic contrast medium before o peration. The surgical procedures included open Bristow operation in 25, Bankart operation in 3, Putti-Platt operation in 2, and a combination of Bankart and ca psular tightness operation by arthroscopy in 1. Each patient also underwent arth roscopy or open surgery and the observations were compared with CTA. Results Les ions of labrum and capsulo-ligamentous complex were the two most common abnormal ities demonstrated by surgical findings, which were respectively found in 28 and 20 patients at surgery. Anterior glenoid labral abnormalities, including of tea r, detachment, degeneration, were detected on CTA in 26 of 28, 2 of glenoid labr al degeneration were undetected on CTA, and the accuracy rate diagnosis on CTA w as 93.5%, while the sensitivity of CTA was 92.8%. Capsular lesions, including of marked medial scapular insertion, glenoid marginal stripping, and loss of inter vening scapular marginal soft tissues, were detected on CTA in 19 of 20, 1 of ca psular glenoid marginal stripping was undetected on CTA, and the accuracy rate d iagnosis on CTA was 87.1%, while, the sensitivity of CTA was 95%. Subscapularis tendon abnormalities, including of tears and irregularities, were visualized in 7 cases on CTA, but only 4 of which were identified during surgery. Furthermore, all of 15 Hill-Sachs defects, 6 Bankart bony defects, and 1 rupture of supraspi natus tendon suggested by CTA, were identified during surgery. For 26 of the pat ients with above kinds of lesion resulting in recurrent anterior glenohumeral di slocation, the accuracy rate of diagnosis was 83.7%. Conclusion The utilization of CT double-contrast arthrography can improve the understanding of multiple les ions associated with recurrent shoulder dislocation, it is contributed to select proper operative procedure.
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Objective To investigate the result of McBride operation for treatment of hallux valgus with more than 5 years follow-up. Methods There were totally fifity patients who underwent McBride operation in this study. The follow-up period varied from 5 years to 10 years and 2 months (average 7 years and 1 month). The symptoms and deformity before and after operation were compared statisticly. Results The angle between first phalanx and metatarsal is strongly correlated with the angle between first and second metatarsal.The coefficience of pre- and post-operation is 0.84 and 0.71 respectively.There were 64 feet whose symptoms were eliminated and the deformity were corrected basically. The effective rate was 71.1% according to the assessment criteria discribed by doctor ZHU Lihua. The common complications were pain residue, local numbness, hallux valgus recurrence, hallux varus and claw toes. The measurment showed the angle between first phalanx and metatarsal significantly decreased after operation and the angle between first and second metatarsal also decreased following the hallux valgus correction. Conclusion McBride operation is a good and reliable method to treat young patients with mild to moderate hallux valgus. Complications are related to congenital foot deformity, severe valgus deformity and normal structure injuries during the operation.