Abstract
Objective: The objective of this retrospective study is to evaluate our results with proximal closing-wedge osteotomy of first metatarsal for the treatment of hallux valgus with severe intermetatarsal (IM) angle and normal proximal articular set angle (PASA).
Material and methods: We reviewed 110 patients (141 feet) who had been treated by proximal closing-wedge osteotomy of first metatarsal between March-97 and February-04. 87% were women and the mean age was 47.8 years. A single cannulated screw was used for osteotomy fixation in 82% of patients. Additional procedures as phalangeal osteotomy or Keller resection were done when necessary.
Results: With a mean follow-up of 42.3 months, correction of the deformity was good or excellent in 80.5% of cases and fair in 15.4%. Pain due to bunion disappeared in 94.3% of feet. Mean preop IM (angle) was 17.3 and postop was 7.9. Metatarsal-phalangeal angle improved from 42.4 to 15.9. Fusion was achieved in 6.8 weeks (average). Complications were: hypercorrection in 13 feet (2 required reoperation); recurrence of deformity in 10 feet (1 reoperation); central metatarsalgia in 8 feet. Neither infection nor nonunions were observed. Patient satisfaction was excellent or good in 92.7% of patients.
Conclusion: Proximal closing-wedge osteotomy of first metatarsal is a good technique for the treatment of hallux valgus with severe IM angle and normal PASA. It is an easy and reproducible technique with good results, low number of complications and a high rate of patient satisfaction
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
