Opening first metatarsal osteotomy and resection arthroplasty of the first MPJ in the treatment of first ray insufficiency associated with degenerative hallux valgus☆
Received 21 March 2009; received in revised form 23 July 2009; accepted 15 August 2009. published online 14 September 2009.
Abstract
Background
Opening wedge proximal metatarsal osteotomy combined with first metatarsophalangeal arthroplasty can be used to correct first metatarsus primus varus with a high intermetatarsal angle and a short first metatarsal.
Methods
147 feet in 138 patients with degenerative first metatarsophalangeal arthrosis, ≥15° of metatarsus primus varus and, a short first metatarsal were included. Preoperative and postoperative clinical, radiographic, and subjective outcome measurements were taken (Scale AOFAS).
Results
The mean first intermetatarsal angle decrease was 7.79±1.43° and the mean increase in first metatarsal length was 2.88±0.45mm. The pre-intervention mean values were 52.6 points in the AOFAS scale, and an overall result of 92.95 obtained after surgery (P<0.001).
Conclusions
The opening proximal first metatarsal osteotomy without internal fixation and with first metatarsophalangeal resection arthroplasty can correct severe hallux valgus with an intermetatarsal angle ≥15° and a short first metatarsal, achieving low rate of complications.
Department of Orthopaedic Surgery and Traumatology, Hospital General de Granollers, Granollers, Barcelona, Spain
Corresponding author at: Department of Orthopaedic Surgery and Traumatology, Hospital General de Granollers, Ronda General Mitre 38, PO. Box 08017, Granollers, Barcelona, Spain. Tel.: +34 657342997; fax: +34 932000694.
☆ Level of clinical evidence: 4. Case series study.
ABSTRACT