ABSTRACT
BACKGROUND: Proximal osteotomy of the first metatarsal is often indicated for Hallux Valgus correction. Previously recognised complications however, include transfer metatarsalgia, first metatarsophalangeal joint stiffness, problems with fixation and prominence of metalware. METHODS: We report on one year follow up of an international prospective series between June 2009 and October 2012 involving three centres, including 91 feet (58 patients) that underwent proximal osteotomy, using a new locking plate applied to the plantar surface of the metatarsal. RESULTS: Mean Hallux Valgus angle improved from 27.9 (±13.1)° to 12.4 (±8.2)° while mean Intermetatarsal angle improved from 12.5 (±8.4) to 7.1 (±3.4) and there was a statistically significant improvement in both mean AOFAS-HMI score 54.2 (±13.9) to 94.0 (±9.5) and Visual Analogue Pain Scale 4.7 (±1.5) to 0.6 (±1.3). 70% of patients were back at their preoperative employment at five weeks. Mean surgical time was 56min and the plate was generally well tolerated. There were five implant related complications. CONCLUSIONS: Locked fixation from the tension side of the construct encourages early weight bearing with a low risk of implant prominence. Our radiological, functional and clinical parameters are comparable with similar series and we therefore recommend this technique.
Subject(s)
Bone Plates , Fracture Fixation, Internal/instrumentation , Hallux Valgus/surgery , Osteotomy , Adult , Female , Follow-Up Studies , Hallux Valgus/diagnostic imaging , Humans , Male , Middle Aged , Prospective Studies , Treatment OutcomeABSTRACT
As the final step of correction of hallux valgus deformity, the great toe proximal phalanx osteotomy is useful. It is popular in France and throughout Europe. Our purpose is to distinguish and to describe different locations and three types of osteotomies according to the required final correction of the hallux valgus.
