Fixation of the Proximal Metatarsal Crescentic Osteotomy Using a Head Locking X-Plate

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Biomechanics

Background:

• Hallux valgus is a common foot deformity requiring surgical correction.
• Proximal crescentic osteotomy (PCO) is a surgical technique used to address hallux valgus.
• Stabilization of the osteotomy site is crucial for successful outcomes.

Purpose of the Study:

• To evaluate the stability and efficacy of a head locking X-plate for stabilizing proximal crescentic osteotomies (PCOs).
• To assess clinical outcomes, bone healing, and patient-reported quality of life following PCO with X-plate fixation.

Main Methods:

• A prospective study involving 72 patients (94 feet) with hallux valgus undergoing PCO stabilized with a head locking X-plate.
• Radiographic measurements of osteotomy stability (e.g., first metatarsal head elevation, angles) were taken pre- and postoperatively.
• Secondary outcomes included gait analysis, quality of life surveys (SF36), and assessment of bone healing.

Main Results:

• High percentages of feet showed minimal change in key stability measurements (dorsal elevation, cuneiform height, angles).
• Significant improvements were observed in patient quality of life, including physical function, general health, and pain reduction.
• Weight distribution analysis indicated reduced pressure under the second and third metatarsal heads post-surgery.

Conclusions:

• The head locking X-plate provides a stable and reproducible method for PCO fixation in hallux valgus correction.
• This technique leads to satisfactory bone healing, improved clinical outcomes, and enhanced patient satisfaction.
• The X-plate offers substantial support, facilitating adequate and straightforward fixation of the PCO.