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TRIPLE OSTEOTOMY FOR TREATMENT OF SEVERE HALLUX VALGUS



Abstract

During a 3-year period in which 348 hallux valgus correction were performed, 10 patients with symptomatic hallux valgus deformity underwent triple osteotomies. All the 10 patients had intermetatarsal 1–2 angle of over 20 degrees and DMAA angle of over −10 degrees and no degenerative changes at MTP joint. They were studied retrospectively at an average follow-up of 9.7 months.

The surgical technique comprised a proximal open medial based wedge first metatarsl osteotomy and a distal closing medial based wedge first metatarsal osteotomy and a closing medial basal wedge phalangeal osteotomy. The average age of the patients at the time of surgery was 53.4 years.

At final follow-up, the average hallux valgus correction measured 22 degrees and the average intermetatarsal 1–2 angle correction was 9 degrees postoperatively. The DMAA averaged −4 degrees postoperatively the average length of the 1st metatarsal was shorter 2.43 mm postoperatively.

The average of the (VAS FA) score was improved from 55 preoperatively to 83.9 postoperatively.

8 patients were very satisfied, one patient was satisfied and one patient was unsatisfied. A hallux valgus deformity with an increased 1–2 intermetatasal angle over 20 degrees can be successfully treated with triple first ray osteotomies that maintain articular congruity of the the first metatarsophalangeal joint.

Correspondence should be addressed to Mr Richard Wallace at Musgrave Park Hospital, 20 Stockman’s Lane, Belfast BT9 7JB, Northern Ireland.