ABSTRACT
PURPOSE: We made a radiological comparison between 60 degrees distal Chevron osteotomy with short armed two parts and 40 degrees distal Chevron osteotomy with long armed one part performing operation in cases of hallux valgus angle of less than 40 degrees, intermetatarsal angle of less than 15 degrees. MATERIALS AND METHODS: 12 cases with 60 degrees distal Chevron osteotomy and 12 cases with 40 degrees distal Chevron osteotomy were selected from October 2000 to March 2005. We have analysed the hallux valgus angle, 1-2 intermetatarsal angle, metatarsal length, distal metartarsal articular angle and angulation at osteotomy site on lateral view in each radiological films taken at preoperative, postoperative and 3 months after operation presuming bone union. All cases were women, both sides were 9 cases and average age was 52.3 years old. RESULTS: Data taken at preoperative, postoperative and 3 months follow up films in 60 degrees distal Chevron osteotomy were as follows; the hallux valgus angles were 32.1 degrees, 10.9 degrees, 13.8 degrees, the 1-2 intermetatarsal angles were 13.6 degrees, 8.5 degrees, 8.4 degrees, the metatarsal length were 60.6 mm, 58.8 mm, 58 mm, the distal metartarsal articular angles were 13 degrees, 6 degrees, 6.6 degrees and 3 cases were over 3 degrees angulation at lateral view. In 40 degrees distal Chevron osteotomy, the hallux valgus angles were 34.5 degrees, 11.6 degrees, 15.3 degrees, the 1-2 intermetatarsal angles were 12.7 degrees, 8.2 degrees, 7.8 degrees, the metatarsal length were 59.2 mm, 56.9 mm, 55.9 mm, the distal metartarsal articular angles were 12 degrees, 7.3 degrees, 7.3 degrees and there were no case with angulation over 3 degrees at lateral view. CONCLUSION: In comparison between 60 degrees distal Chevron osteotomy and 40 degrees distal Chevron osteotomy measuring at postoperative and follow up, most of all data were similar, but 3 cases over 3 degrees angulation at lateral view happened in 60 degrees Chevron osteotomy. This result showed that 40 degrees distal Chevron osteotomy fixing with screws through long armed one part may have benefit than 60 degrees distal Chevron osteotomy fixing with K-wires through short armed two parts in making rigid fixation, even though there is a personal difference of technigue.
Subject(s)
Female , Humans , Arm , Follow-Up Studies , Hallux Valgus , Hallux , Metatarsal Bones , OsteotomyABSTRACT
PURPOSE: We made a radiological comparison between 60 degrees distal Chevron osteotomy with short armed two parts and 40 degrees distal Chevron osteotomy with long armed one part performing operation in cases of hallux valgus angle of less than 40 degrees, intermetatarsal angle of less than 15 degrees. MATERIALS AND METHODS: 12 cases with 60 degrees distal Chevron osteotomy and 12 cases with 40 degrees distal Chevron osteotomy were selected from October 2000 to March 2005. We have analysed the hallux valgus angle, 1-2 intermetatarsal angle, metatarsal length, distal metartarsal articular angle and angulation at osteotomy site on lateral view in each radiological films taken at preoperative, postoperative and 3 months after operation presuming bone union. All cases were women, both sides were 9 cases and average age was 52.3 years old. RESULTS: Data taken at preoperative, postoperative and 3 months follow up films in 60 degrees distal Chevron osteotomy were as follows; the hallux valgus angles were 32.1 degrees, 10.9 degrees, 13.8 degrees, the 1-2 intermetatarsal angles were 13.6 degrees, 8.5 degrees, 8.4 degrees, the metatarsal length were 60.6 mm, 58.8 mm, 58 mm, the distal metartarsal articular angles were 13 degrees, 6 degrees, 6.6 degrees and 3 cases were over 3 degrees angulation at lateral view. In 40 degrees distal Chevron osteotomy, the hallux valgus angles were 34.5 degrees, 11.6 degrees, 15.3 degrees, the 1-2 intermetatarsal angles were 12.7 degrees, 8.2 degrees, 7.8 degrees, the metatarsal length were 59.2 mm, 56.9 mm, 55.9 mm, the distal metartarsal articular angles were 12 degrees, 7.3 degrees, 7.3 degrees and there were no case with angulation over 3 degrees at lateral view. CONCLUSION: In comparison between 60 degrees distal Chevron osteotomy and 40 degrees distal Chevron osteotomy measuring at postoperative and follow up, most of all data were similar, but 3 cases over 3 degrees angulation at lateral view happened in 60 degrees Chevron osteotomy. This result showed that 40 degrees distal Chevron osteotomy fixing with screws through long armed one part may have benefit than 60 degrees distal Chevron osteotomy fixing with K-wires through short armed two parts in making rigid fixation, even though there is a personal difference of technigue.
Subject(s)
Female , Humans , Arm , Follow-Up Studies , Hallux Valgus , Hallux , Metatarsal Bones , OsteotomyABSTRACT
PURPOSE: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. MATERIALS AND METHODS: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. RESULTS: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. CONCLUSION: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.
Subject(s)
Female , Humans , Male , Ankle , Ankle Fractures , Classification , Follow-Up Studies , Postoperative Complications , Retrospective Studies , Soft Tissue Injuries , Weight-BearingABSTRACT
PURPOSE: We evaluated the clinical results of operative treatment of the intraarticular calcaneal fracture according to fracture classification. MATERIALS AND METHODS: There were 25 cases (24 patients) which had at least one year follow up, 17 men and 7 women who were treated from June 1997 to March 2003. We have analysed the Bohler's angle, cruciate angle, width and posttraumatic osteoarthritis in radiological evaluation, and evaluated clinical results according to the Creighton-Nebraska health foundation score. RESULTS: Excellent results were noted in 7 cases, good results in 6 cases, fair results in 4 cases and poor results in 8 cases. Radiological changes showed as follows: Bohler angle 17 degrees, Crucial angle 0.1 degrees, Width 6mm. CONCLUSION: Type II showed satisfactory results and type IV showed unsatisfactory results in Sanders classification. Proper evaluation of the intraarticular calcaneal fracture by X-ray and CT scan is necessory to predict prognosis and decise method of operative treatment.