Résumé
PURPOSE: This study analyzed the clinical and radiographic outcome of the severe hallux valgus corrected with proximal reverse chevron metatarsal osteotomy and Akin osteotomy. MATERIALS AND METHODS: The study was based on 18 feet (15 patients) of severe hallux valgus (hallux valgus angle> or =40degrees or intermetatarsal angle> or =18degrees) treated with proximal reverse chevron metatarsal osteotomy and followed for more than 1 year. Akin osteotmy was added in 72% of the patients. Clinically preoperative and postoperative AOFAS Hallux Metatarsophalangeal - interphalangeal score, VAS pain score and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. RESULTS: AOFAS Hallux Metatarsophalangeal - interphalangeal score improved from 54.5 (25-78) to 87.7 (70-100) and VAS pain score decreased from 6.0 (3-8) to postoperative 1.2 (0-5). Ninety-six percents of the patients were satisfied with results. Radiologically hallux valgus angle was decreased from 43.3degrees(31-58degrees) preoperatively to 6.8degrees (-8-27degrees) postoperatively. The intermetatarsal angle was decreased from 18.4degrees(11-24degrees) preoperatively to 5.3degrees (1-12degrees) postoperatively. The sesamoid subluxation was improved from 2.8+/-0.4 preoperatively to 0.4+/-0.6 postoperatively. CONCLUSION: Proximal reverse chevron metatarsal osteotomy and lateral soft tissue release with additional Akin osteotomy is good treatment option for severe hallux valgus.
Sujets)
Humains , Malformations , Pied , Hallux , Hallux valgus , Os du métatarse , OstéotomieRésumé
PURPOSE: This study analyzed the clinical and radiographic outcome of the severe hallux valgus corrected with proximal reverse chevron metatarsal osteotomy and Akin osteotomy. MATERIALS AND METHODS: The study was based on 18 feet (15 patients) of severe hallux valgus (hallux valgus angle> or =40degrees or intermetatarsal angle> or =18degrees) treated with proximal reverse chevron metatarsal osteotomy and followed for more than 1 year. Akin osteotmy was added in 72% of the patients. Clinically preoperative and postoperative AOFAS Hallux Metatarsophalangeal - interphalangeal score, VAS pain score and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. RESULTS: AOFAS Hallux Metatarsophalangeal - interphalangeal score improved from 54.5 (25-78) to 87.7 (70-100) and VAS pain score decreased from 6.0 (3-8) to postoperative 1.2 (0-5). Ninety-six percents of the patients were satisfied with results. Radiologically hallux valgus angle was decreased from 43.3degrees(31-58degrees) preoperatively to 6.8degrees (-8-27degrees) postoperatively. The intermetatarsal angle was decreased from 18.4degrees(11-24degrees) preoperatively to 5.3degrees (1-12degrees) postoperatively. The sesamoid subluxation was improved from 2.8+/-0.4 preoperatively to 0.4+/-0.6 postoperatively. CONCLUSION: Proximal reverse chevron metatarsal osteotomy and lateral soft tissue release with additional Akin osteotomy is good treatment option for severe hallux valgus.