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An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
Published on: February 17, 2018
Modified crescentic proximal metatarsal osteotomy and distal soft tissue procedures in hallux valgus
Barbaros Baykal1, Vecihi Kirdemir, A Sabri Ateşalp
1Department of Orthopedics and Traumatology, Gulhane Military Medical Academy, Etlik 06018, Ankara, Turkey.
Insights
This study shows that a modified crescentic proximal metatarsal osteotomy effectively corrects hallux valgus deformity in military personnel, significantly improving patient satisfaction and foot function scores.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Podiatric Medicine
Background:
- Hallux valgus deformity, particularly when symptomatic and incongruent at the metatarsophalangeal joint, significantly impacts patient quality of life.
- Surgical correction is often necessary for severe cases, with various osteotomy techniques described.
- Proximal metatarsal osteotomies aim to correct the deformity by repositioning the metatarsal bone.
Purpose of the Study:
- To evaluate the efficacy of a modified crescentic proximal metatarsal osteotomy combined with distal soft tissue procedures.
- To assess surgical outcomes in a cohort of male military personnel with symptomatic hallux valgus.
- To analyze radiographic and functional improvements following the surgical intervention.
Main Methods:
- A retrospective review of 49 feet from 41 male military patients undergoing the procedure.
- Evaluation using the American Orthopedic Foot and Ankle Society (AOFAS) forefoot scoring system.
- Radiographic assessment of hallux valgus angle and intermetatarsal angle pre- and post-operatively.
Main Results:
- Significant improvement in AOFAS scores from a mean of 54.4 preoperatively to 95.4 postoperatively.
- Mean hallux valgus angle corrected from 39.4 to 12.8 degrees (26.6-degree correction).
- Mean intermetatarsal angle corrected from 15.9 to 7.1 degrees (8.8-degree correction); 93.8% patient satisfaction.
Conclusions:
- The modified crescentic proximal metatarsal osteotomy is a safe and effective procedure for correcting symptomatic hallux valgus.
- The technique yields high patient satisfaction and significant radiographic and functional improvements.
- Further research could explore specific modifications and long-term outcomes compared to other surgical methods.
Abstract:
The results of a modified crescentic proximal metatarsal osteotomy and distal soft tissue procedures for patients with symptomatic, incongruent, metatarsophalangeal joint, hallux valgus deformity were reviewed. Forty-nine feet of 41 patients were evaluated. All of the patients were male military personnel of different ranks, and their mean age was 23 years (range, 20-43 years). The mean follow-up period was 25 months (range, 10-60 months). The patients were evaluated according to the American Orthopedic Foot and Ankle Society forefoot scoring system. The mean preoperative score was 54.4, and the mean postoperative score was 95.4. The mean hallux valgus angle was 39.4 degrees before surgery and 12.8 degrees after surgery (26.6 degrees correction); the mean intermetatarsal angle was 15.9 degrees before surgery and 7.1 after surgery (8.8 degrees correction). A total of 93.8% of the patients were satisfied with the results of the procedure. Complications included delayed union in one case and superficial wound infections in two cases. We also emphasize small modifications performed while shifting the metatarsal shaft laterally and compare the results of our study with those of similar studies.
