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Hallux Valgus Correction with Bunionectomy, Lateral Release, and Proximal Opening Wedge Osteotomy Using Wedge-Plate
1Dalhousie University, Queen Elizabeth II Health Sciences Center Halifax Infirmary, Suite 4867, 1796 Summer Street, Halifax, NS B3H3A7, Canada.
Introduction:
Treatment of hallux valgus with an increased intermetatarsal angle (approximately 12° to 20°) involves surgical correction of the hallux valgus by performing a bunionectomy, lateral release, and proximal opening wedge osteotomy of the first metatarsal.
Step 1 Bunionectomy:
Perform a bunionectomy using a plantar and medial approach over the metatarsophalangeal joint.
Step 2 Lateral Metatarsophalangeal Joint Release:
Release the contracted soft tissues lateral to the metatarsophalangeal joint to allow reduction of the noncongruent metatarsophalangeal joint using a 1 to 2-cm incision in the web space.
Step 3 Proximal Opening Wedge Osteotomy:
Make the proximal opening wedge osteotomy through a dorsal medial incision.
Step 4 Wound Closure:
Close the wounds using nylon sutures, and apply sterile dressings and a cast.
Step 5 Postoperative Course:
Patients are restricted to non-weight-bearing and then are progressed to full weight-bearing.
Results:
Hallux valgus surgical correction, using a bunionectomy, lateral release, and a proximal opening wedge osteotomy, was performed for the treatment of hallux valgus with an increased intermetatarsal angle in a randomized controlled trial.IndicationsContraindicationsPitfalls & Challenges.
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