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Related Experiment Videos

Adding stability to the crescentic basilar first metatarsal osteotomy.

Brian Carpenter1, Travis Motley

  • 1Podiatry Section, Department of Orthopaedics, John Peter Smith Hospital, Fort Worth, TX 76104, USA.

Journal of the American Podiatric Medical Association
|September 21, 2004
PubMed
Summary

A modified crescentic basilar osteotomy with a plantar shelf improves fixation and reduces first metatarsal elevation in hallux valgus surgery. This technique offers substantial correction for metatarsus primus varus and hallux valgus deformities.

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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Surgery
  • Skeletal Biomechanics

Background:

  • Metatarsus primus varus and hallux valgus are common foot deformities.
  • Crescentic basilar osteotomies are used for correction but have fixation and stability challenges.
  • Sagittal plane instability and difficulty in fixation are known pitfalls of standard crescentic osteotomies.

Purpose of the Study:

  • To describe a novel modification of the crescentic basilar osteotomy by incorporating a plantar shelf.
  • To evaluate the efficacy and safety of this modified technique in correcting metatarsus primus varus and hallux valgus.
  • To assess the impact of the plantar shelf on first metatarsal fixation and postoperative position.

Main Methods:

  • A prospective study involving 20 patients undergoing crescentic basilar osteotomy with a plantar shelf.

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  • The plantar shelf was created in the metaphyseal portion of the first metatarsal.
  • Surgical outcomes, including correction of the first intermetatarsal angle and hallux valgus angle, were measured.
  • Postoperative first metatarsal elevation was assessed at eight weeks.

    • Main Results:

    • Significant average reduction of 9.3 degrees in the first intermetatarsal angle.
    • Substantial average reduction of 21.8 degrees in the hallux valgus angle.
    • Only one patient (5%) experienced first metatarsal elevation at eight weeks postoperatively.
    • The addition of the plantar shelf facilitated easier fixation and improved stability.

    Conclusions:

    • The crescentic basilar osteotomy with a plantar shelf is an effective modification for correcting metatarsus primus varus and hallux valgus.
    • This technique enhances fixation and minimizes the risk of postoperative first metatarsal elevation.
    • The plantar shelf promotes better bone healing due to its metaphyseal placement.
    • This approach offers a valuable alternative for surgeons treating complex forefoot deformities.