Treatment of hallux valgus deformity : Preliminary results with a modified distal metatarsal osteotomy


Published online: Oct 27 2009

Naeder Helmy, Patrick Vienne, Arndt von Campe, Norman Espinosa

From Balgrist Hospital, University of Zurich, Zurich, Switzerland

Abstract

This study aimed to investigate the preliminary results achieved with a modified distal first metatarsal osteotomy (reversed L-shaped) for correction of moderate and severe hallux valgus deformities. This prospective study included 31 patients (39 feet) with a mean age of 56 years. All patients underwent a reversed L-shaped osteotomy of the first metatarsal. At follow-up all patients were reviewed clinically and radiologically. Patients were categorized into two groups (MTP angle A : < 20°, and B : 20-40°). The AOFAS score improved from 53 points to 91 points at follow-up (p < 0.0001). Group A showed an increase from 56 to 90 points (p = 0.003), group B from 52 to 92 points (p < 0.0001). The mean 1-2-intermetarsal angle (IMA) decreased from 12.5° preoperatively to 8° at follow-up (p < 0.005) : from from 11° to 9° in group A (p = 0.09) and from from 13° to 7° in Group B (p < 0.0001). No nonunion or avascular necrosis was observed. One diabetic patient developed a resistant postoperative infection. The L-shaped osteotomy provided good and excellent clinical as well as radiological results in the mild and moderate-to-severe hallux valgus deformities treated. The mid- and long-term effect of this type of osteotomy needs to be further investigated.