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Fixation of first metatarsal basal osteotomy using Acutrak screw
G E Fadel1, S M Hussain, S Sripada
1Department of Orthopaedics & Trauma, Ninewells Hospital & Medical School, Dundee, UK. GFadel@nhs.net
Background:
The purpose of this study is to determine clinical and radiological outcome following the internal fixation of first metatarsal basal osteotomy using Acutrak screw.
Methods:
Between May 1999 and December 2003, 37 feet undergoing basal closing wedge osteotomy were stabilised using Acutrak screw. The minimum follow-up period was 18 months. The position and fate of the screw, complications, hallux valgus, intermetatarsal and metatarsal declination angles, and time for bony union were assessed postoperatively and at the final follow-up.
Results:
Seventy-nine percent of the corrected feet had achieved excellent or good AOFAS score, 13% fair, and 8% poor score. The average preoperative intermetatarsal, hallux valgus and first metatarsal declination angles were 17.3 degrees (12-20 degrees), 38 degrees (17-53 degrees) and 22.5 degrees (16-30 degrees), respectively. These were reduced to 10.3 degrees (0-16 degrees), 14.6 degrees (9-26 degrees) and 20.4 degrees (16-26 degrees) following surgery and 11.2 degrees (0-18 degrees), 16.0 degrees (12-22 degrees) and 20.1 degrees (16-23 degrees), respectively, at the final follow-up. Clinical and radiological union has been achieved in all cases.
Conclusion:
Our technique provides stable fixation with minimal loss of position at the osteotomy site.
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