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The Journal of Bone and Joint Surgery, Vol 74, Issue 1 124-129, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
Repair of hallux valgus with a distal soft-tissue procedure and proximal metatarsal osteotomy. A long-term follow-up
RA Mann, S Rudicel and SC Graves
Department of Orthopaedics, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141.
We retrospectively reviewed the results for seventy-five patients (109
feet) in whom a hallux valgus deformity had been corrected with the release
of the distal soft tissues, excision of the medial eminence, plication of
the medial part of the capsule, and proximal crescentic osteotomy of the
first metatarsal. The patients were followed for an average of thirty-four
months (range, twenty-four to fifty-six months). The preoperative hallux
valgus angle averaged 31 degrees, and the postoperative angle averaged 9
degrees. The preoperative intermetatarsal angle averaged 14 degrees and the
postoperative angle, 6 degrees. Ninety-three per cent of the patients were
satisfied with the result of the procedure. They stated that, given the
same circumstances, they would have the operation again. The most common
complication was hallux varus, which occurred in thirteen feet (nine
patients). The other complications included recurrence of the hallux valgus
in two feet, pain under a fibular sesamoid in one foot, and a tailor's
bunion that was unrelated to the operation in one foot. Only five of
forty-eight feet that had had a symptomatic plantar keratosis beneath the
second metatarsal head preoperatively remained symptomatic postoperatively.
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