Metatarsal osteotomy for the treatment of hallux valgus

One hundred feet in 85 patients operated upon for correction of symptomatic hallux valgus deformity. The age of patients ranged from 14 to 60 years. Seventy patients had unilateral operation while 15 patients had been operated upon bilaterally. Forty-four patients were females and 41 were males. Distal metatarsal osteotomies. Mitchell, modified Hohmann, and chevron techniques were performed as well as Wilson oblique osteotomy. The results were rated excellent and good in 84.4% in Wilson group, 62.4% in Mitchell group, 64.7% in modified Hohmann group and 50% in chevron group. The Wilson oblique osteotomy is technically uncomplicated and yields a high percentage of satisfactory results. Modified Hohmann and the Mitchell osteotomies inspite of their technical demand had been found relatively simple and the results were uniformly good. The three osteotomies were found to be the proven methods of surgery recommended in adolescent and young adults and even older patients provided that there are no degenerative changes. Chevron osteotomy inspite of being straightforward and simple procedure, yet it is recommended in the treatment of patients who have limited degree of deformity

Results of surgical decompression of the median nerve in pronator teres syndrome

Fifteen patients with pronator teres syndrome were treated surgically by decompression of the median nerve. The age of the patients varied between 19 and 45 years with the average of 29.5 years. The follow-up period was ranging between 8 and 30 months with the average of 15 months. The pronator teres syndrome was diagnosed clinically by aching discomfort and easy fatigability of the muscles of the forearm brought by cyclic stress, tenderness over the proximal part or pronator teres muscle which was aggravated by resisted pronation of the forearm. Electrophysiological testing was done for the median and ulnar nerves on both sides. Surgical exploration of the median nerve at the elbow showed intramuscular tendinous bands in the pronator teres muscle in 7 patients, thickened lacertus fibrosus in 3 patients, tough fibrous arch of flexor digitorum superficialis in 3 patients and no abnormality was found in two patients. Surgical decompression of the median nerve gave excellent results in 47.7% of cases good results in 20% of cases, fair results in 20% of cases, and poor results in 13.3% of cases. The best results were found in whom a definite anatomical constriction was found and the patients who did not improve were those in whom the findings were less obvious. Favourable results are clearly related to proper diagnosis