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General Orthopaedics

Results of osteotomy of the base of the first metatarsal for hallux valgus

The South African Orthopaedic Association (SAOA) 58th Annual Congress



Abstract

Aim

To assess if immediate post-operative weight bearing has a negative influence on the results of osteotomy plus distal soft tissue repair to correct hallux valgus.

Design

The results of a crescentic osteotomy plus distal soft tissue repair with Akin osteotomy added as indicated were assessed in 61 consecutive cases. Thirty five were bilateral. This gives a total of 96 feet. During this time other procedures were also performed for hallux valgus.

Results

The mean age of the patients was 54 years [16–79]. Measurements of the angles were done pre-operatively, at six weeks post op and at the time of final follow-up, at least three months post-surgery. Only one case was totally lost to follow-up, although in some cases some of the measurements were lost or could not be retrieved.

The mean pre-operative angle between first and second metatarsals was 14.8° and the hallux valgus angle was 29.8°

The average decrease of the intermetatarsal angle at six weeks was 5.9° and at final follow-up 5.5°.

The correction of the hallux valgus at six weeks averaged 13.3° and at final follow-up 13°.

Repair of an adjacent clawed second toe was done in 25 of the feet. A number of other smaller procedures were also done in a small number of cases.

Superficial sepsis was present in two cases, both cleared up on treatment.

In three cases it appeared that non-union was developing.

In four feet hallux valgus was still present to a significant degree and these were classified as failures. The failures will be analysed and discussed endeavouring to recognise the reasons for failure.

Conclusion

Immediate post-surgical weight bearing does not compromise the results of crescentic osteotomy plus distal soft tissue procedure after surgery for hallux valgus.

MULTIPLE DISCLOSURES