ABSTRACT
BACKGROUND: This study aimed to evaluate the clinical and radiological outcome after cheilectomy and proximal phalangeal biplanar osteotomy for patients with mild and advanced stages of hallux rigidus. METHODS: A total of 105 feet (grades 0-4) were treated with cheilectomy and a Moberg-Akin osteotomy of the proximal phalanx. All patients were clinically assessed preoperatively and followed up for 12 months by range of motion, visual analog scale (VAS) pain score, American Orthopaedic Foot & Ankle Society (AOFAS) score, Short Form 36 (SF-36) score, and weightbearing radiographs. RESULTS: This operative procedure resulted in a statistically significant positive effect on mobility of the first metatarsophalangeal joint (P = .001), VAS pain score (P < .001), AOFAS score (P < .001), and SF-36 score (P < .001). CONCLUSION: Cheilectomy and biplanar osteotomy of the proximal phalanx was an effective procedure for hallux rigidus with a positive effect on clinical and radiological outcome. LEVEL OF EVIDENCE: IV, case series.
Subject(s)
Hallux Rigidus/diagnostic imaging , Hallux Rigidus/surgery , Osteotomy/methods , Toe Phalanges/diagnostic imaging , Toe Phalanges/surgery , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pain Measurement , Prospective Studies , Quality of Life , Radiography , Range of Motion, Articular , Surveys and Questionnaires , Young AdultABSTRACT
BACKGROUND: Scarf midshaft metatarsal osteotomy has become increasingly popular as a treatment option for moderate-to-severe hallux valgus deformities because of its great versatility. Numerous studies on Scarf osteotomy have been published. However, no prospective studies were available until 2002. Since then, only short-term follow-up prospective studies have been published. We present the results of a prospective study of 21 patients treated by Scarf osteotomy for hallux valgus with follow-up of 8 years. METHODS: Between August 1, 1999, and October 31, 1999, 23 patients (23 feet) with moderate-to-severe hallux valgus deformity were included. Clinical (American Orthopaedic Foot and Ankle Society score) and radiologic (hallux valgus angle, first intermetatarsal angle, and sesamoid position) evaluations were performed preoperatively and 1 and 8 years postoperatively. RESULTS: Clinical evaluation showed a significant improvement in the mean forefoot score from 47 to 83 (of a possible 100) at 1 year (P < .001). Radiographic evaluation showed significant improvement in the hallux valgus angle (mean improvement, 19 degrees ; P < .001) and in the intermetatarsal angle (mean improvement, 6 degrees ; P < .001). These clinical and radiographic results were maintained at the final evaluation 8 years postoperatively. CONCLUSIONS: Scarf osteotomy tends to provide predictable and sustainable correction of moderate-to-severe hallux valgus deformities.
Subject(s)
Hallux Valgus/surgery , Osteotomy/methods , Adolescent , Adult , Aged , Female , Follow-Up Studies , Hallux Valgus/diagnostic imaging , Humans , Male , Metatarsal Bones/diagnostic imaging , Middle Aged , Prospective Studies , Radiography , Sesamoid Bones/diagnostic imagingABSTRACT
A group of 19 patients who underwent knee arthrodesis with use of an intramedullary nail between 1996 and 2005, was studied. In the majority of patients knee arthrodesis was performed as a salvage procedure for the limb following an infected total knee arthroplasty. The outcome of the procedure was evaluated with radiographs, the SF-36 score and the Oxford 12-item knee score. The functional result of a successful arthrodesis was found to be comparable with that of a revised hinged total knee arthroplasty. Knee arthrodesis with an intramedullary nail allows weightbearing within 1 week and is accompanied by a high rate of pain relief. However, recurrence of infection is the most challenging problem.
