A variable first metatarsal distal "L" osteotomy with adductor tendon transfer

Area of Science:

• Orthopedic Surgery
• Podiatric Medicine
• Skeletal Biomechanics

Background:

• Hallux abducto valgus (HAV) is a common foot deformity.
• Correction of severe HAV, particularly with high intermetatarsal angles, can be challenging, especially in elderly patients.
• Traditional surgical options may involve significant morbidity or suboptimal correction in specific patient populations.

Purpose of the Study:

• To present a modified surgical approach for hallux abducto valgus.
• To evaluate the utility of combining adductor tendon transfer with distal metaphyseal osteotomy.
• To assess the effectiveness of this technique in elderly patients with high intermetatarsal angles.

Main Methods:

• A modified surgical technique involving adductor tendon transfer through a distal metaphyseal osteotomy was performed.
• The procedure was applied to a cohort of seven elderly patients diagnosed with hallux abducto valgus and high intermetatarsal angles.
• Patient outcomes were retrospectively reviewed as a preliminary report.

Main Results:

• The modified surgical approach demonstrated utility in correcting hallux abducto valgus in the studied patient group.
• The technique was found to be particularly useful for elderly patients with high intermetatarsal angles.
• Preliminary results suggest this method can provide optimal correction, potentially avoiding proximal-type procedures.

Conclusions:

• A modified surgical technique combining adductor tendon transfer and distal metaphyseal osteotomy is a viable option for treating hallux abducto valgus.
• This approach shows promise for elderly patients with significant deformity (high intermetatarsal angle).
• Further investigation with larger cohorts is warranted to confirm these preliminary findings.