Correction of hallux valgus with metatarsocuneiform stabilization

Area of Science:

• Orthopedic Surgery
• Podiatric Medicine
• Foot and Ankle Reconstruction

Background:

• Hallux valgus (bunion) is a common foot deformity.
• Traditional McBride bunionectomy may have limitations in severe cases.
• Metatarsocuneiform stabilization aims to address first ray instability.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of a modified McBride bunionectomy with metatarsocuneiform stabilization.
• To assess the effectiveness of this procedure in correcting moderate to severe hallux valgus.
• To determine if bone grafting impacts joint fusion and clinical results.

Main Methods:

• Retrospective review of 51 feet in 30 patients.
• Modified McBride bunionectomy with metatarsocuneiform stabilization and bone grafting.
• Clinical and radiographic evaluation at an average of 27.6 months post-surgery.
• Measurement of intermetatarsal angle and assessment of first metatarsal position.

Main Results:

• Significant reduction in average intermetatarsal angle from 14.6 to 8.7 degrees.
• Definite trabecular bridging (fusion) observed in only 25.5% of cases on anteroposterior X-ray.
• Metatarsocuneiform joint remained asymptomatic irrespective of radiographic fusion.
• Procedure successfully corrected moderate and severe deformities, preventing transfer metatarsalgia.

Conclusions:

• Modified McBride bunionectomy with metatarsocuneiform stabilization is an effective treatment for moderate to severe hallux valgus.
• Radiographic evidence of fusion is not essential for successful clinical outcomes.
• The technique restores near-normal foot anatomy, improving function and reducing pain.