Osteotomy of the base of the first accompanied with second and/or third metatarsal(s) to treat hallux valgus / 中华骨科杂志

ABSTRACT

Objective To retrospective analyze the treatment of hallux valgus with the procedure of osteotomy of the base of the first metatarsal, combining with osteotomy of the base of the second and/or third metatarsal(s), and to study the indications and effects of this procedure. Methods 35 cases 56 hallux valgus feet were treated by operative procedure from January 1994 to December 2003. 26 cases 43 feet underwent the operative procedure of osteotomy of the base of the first metatarsal, 9 cases 13 feet with painful callus under the second and/or third metatarsal(s) head underwent osteotomy of the base of the first, second and/or third metatarsal(s). The axial and lateral films of all feet with loading were taken before and after operation. The change of anatomic indexes and AOFAS of the patient postoperatively were recorded and analyzed. Results In the group with osteotomy of the base of the first metatarsal, AOFAS score was 47.6?5.8 preoperatively, and 84.3?5.7 postoperatively. In the group with osteotomy of the base of the first, second and/or third metatarsal(s), AOFAS score was 44.7?5.7 preoperatively, and 85.7?4.5 postoperatively. There were significant differences between the preoperative and postoperative rontgenographic index and AOFAS in each group. Conclusion The operative procedure is effective. The operative procedure of osteotomy of the base of the first metatarsal can get good result in moderate and severe hallux valgus patients. Osteotomy of the second and/or third metatarsal(s) were recommended in cases with painful callus under the second and/or third metatarsal(s). Normal forefoot appearance and function can be restored by the procedure to reestablish the transverse arch.