Operative Treatment for Hallux Valgus With Moderate to Severe Metatarsus Adductus.
Adult
Aged
Cohort Studies
Comorbidity
Female
Hallux Valgus
/ diagnostic imaging
Humans
Male
Metatarsus Varus
/ diagnostic imaging
Middle Aged
Osteotomy
/ methods
Pain Measurement
Pain, Postoperative
/ epidemiology
Prognosis
Range of Motion, Articular
/ physiology
Retrospective Studies
Severity of Illness Index
Treatment Outcome
abduction osteotomy
hallux valgus
metatarsus adductus
operative treatment
Journal
Foot & ankle international
ISSN: 1944-7876
Titre abrégé: Foot Ankle Int
Pays: United States
ID NLM: 9433869
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
pubmed:
9
3
2019
medline:
8
2
2020
entrez:
9
3
2019
Statut:
ppublish
Résumé
Operative treatment is indicated for patients who have symptomatic hallux valgus (HV) with moderate to severe metatarsus adductus (MA). However, there is limited information available on the operative procedures and outcomes for the treatment of HV with MA. We aimed to investigate the average 10-year follow-up clinical and radiologic outcomes. Seventeen patients (21 feet, average age: 60.1 years) with symptomatic HV with moderate to severe MA were operatively treated. Mean postoperative follow-up duration was 114.4 (24-246) months. All feet had metatarsus adductus angle ≥20 degrees on dorsoplantar weight-bearing radiograph. The procedure included a proximal crescentic osteotomy of the first metatarsal and abduction osteotomy of the proximal third of the second and third metatarsals. The mean American Orthopaedic Foot & Ankle Society scale score improved significantly postoperatively ( P < .001). The mean postoperative visual analog scale score (17 feet) was 2.0 (0-6). Preoperative metatarsalgia was severe in 2 feet, moderate in 17, and mild in 2. At the most recent follow-up evaluation, 11 feet had no pain, 9 had mild pain, and 1 had moderate pain. The mean hallux valgus angle, intermetatarsal angle, and metatarsus adductus angle significantly decreased postoperatively ( P < .001 for all). Recurrence of HV (HV angle ≥ 20 degrees) was observed in 4 feet. The clinical and radiologic results indicated that our novel operative treatment for HV with moderate to severe MA can achieve significant correction of HV with MA deformities and significant improvement in pain and function. Level IV, retrospective case series.
Sections du résumé
BACKGROUND
BACKGROUND
Operative treatment is indicated for patients who have symptomatic hallux valgus (HV) with moderate to severe metatarsus adductus (MA). However, there is limited information available on the operative procedures and outcomes for the treatment of HV with MA. We aimed to investigate the average 10-year follow-up clinical and radiologic outcomes.
METHODS
METHODS
Seventeen patients (21 feet, average age: 60.1 years) with symptomatic HV with moderate to severe MA were operatively treated. Mean postoperative follow-up duration was 114.4 (24-246) months. All feet had metatarsus adductus angle ≥20 degrees on dorsoplantar weight-bearing radiograph. The procedure included a proximal crescentic osteotomy of the first metatarsal and abduction osteotomy of the proximal third of the second and third metatarsals.
RESULTS
RESULTS
The mean American Orthopaedic Foot & Ankle Society scale score improved significantly postoperatively ( P < .001). The mean postoperative visual analog scale score (17 feet) was 2.0 (0-6). Preoperative metatarsalgia was severe in 2 feet, moderate in 17, and mild in 2. At the most recent follow-up evaluation, 11 feet had no pain, 9 had mild pain, and 1 had moderate pain. The mean hallux valgus angle, intermetatarsal angle, and metatarsus adductus angle significantly decreased postoperatively ( P < .001 for all). Recurrence of HV (HV angle ≥ 20 degrees) was observed in 4 feet.
CONCLUSION
CONCLUSIONS
The clinical and radiologic results indicated that our novel operative treatment for HV with moderate to severe MA can achieve significant correction of HV with MA deformities and significant improvement in pain and function.
LEVEL OF EVIDENCE
METHODS
Level IV, retrospective case series.
Identifiants
pubmed: 30845841
doi: 10.1177/1071100719835520
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM