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PERCUTANEOUS DISTAL OSTEOTOMY FOR HALLUX VALGUS



Abstract

Many surgical techniques based on a distal osteotomy are used for the treatment of the symptomatic hallux valgus. We review the results of percutaneous distal osteotomy retrospectively.

Between 1998 and 2003, 52 patients were operated on using a distal osteotomy for symptomatic hallux valgus. We investigated 35 females and nine males for a mean follow-up time of 4.6 years. We performed a percutaneous distal osteotomy (PDO) with a 2-mm Kirschner wire. Radiological analysis consisted of measuring the hallux valgus angle (HV) and the angle between the first and the second metatarsal (M). Clinical evaluation was performed with the AOFAS scale.

Good bony contact was achieved and all the osteotomies united and no aseptic necrosis was found. According to the questionnaire, the pre-operative AOFAS score was 44.3 and 92.5 at the follow-up examination. Radiological analysis showed that the pre-operative HV angle was 13.7° and 9.8° at follow-up. The pre-operative M angle was 24.1° and 13.6° at follow-up.

The PDO technique gives good results at a mean follow-up of 4.6 years. The positive aspects of this technique are: short surgical time, low incidence of complications and high patient compliance. A single 2-mm Kirschner wire is enough to achieve adequate stabilisation of the osteotomy, is less expensive than other surgical instruments for hallux valgus and is very easy to remove.