Rigid Internal Fixation of Proximal Crescentic Metatarsal Osteotomy in Hallux Valgus Correction

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Surgical Innovation

Background:

• Hallux valgus is a common foot deformity requiring effective surgical treatment.
• Traditional fixation methods may have limitations.
• Evaluating novel fixation techniques is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the efficacy of a low-profile titanium plate and screw construct for rigid fixation of proximal crescentic osteotomies in hallux valgus treatment.
• To evaluate clinical and radiographic outcomes following this surgical technique.

Main Methods:

• Prospective enrollment of 48 patients (53 feet) with mild to severe hallux valgus.
• Treatment involved proximal crescentic osteotomy fixed with a low-profile titanium plate, with or without Akin osteotomy and distal soft tissue correction.
• Outcomes measured included radiographic changes, pain scores, and American Orthopaedic Foot & Ankle Society (AOFAS) scores over 12 months.

Main Results:

• All osteotomies achieved radiographic union.
• Significant improvements were observed in hallux valgus angle (29° to 9°), 1-2 intermetatarsal angle (14° to 6°), and visual analog scale pain scores (4 to 0.7).
• Mean AOFAS scores improved from 55 to 89, indicating enhanced function and reduced pain.

Conclusions:

• Proximal crescentic metatarsal osteotomy with low-profile titanium plate fixation is a safe and reliable surgical option for hallux valgus.
• The technique effectively corrects deformities and improves patient-reported outcomes.
• Distal soft tissue repair and Akin osteotomy, when indicated, contribute to successful treatment.