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Percutaneous Distal Metatarsal Osteotomy for Correction of Hallux Valgus

¹ Department of Orthopaedics, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy

Investigation performed at the Department of Orthopaedics, University of Verona, Verona, Italy

The original scientific article in which the surgical technique was presented was published in JBJS Vol. 87-A, pp. 1191-1199, June 2005

The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

METHODS: From 1996 to 2001, 118 consecutive percutaneous distal osteotomies of the first metatarsal were performed for the treatment of painful mild-to-moderate hallux valgus in eighty-two patients. The patients were assessed with a clinical and radiographic protocol at a mean of 35.9 months postoperatively. The American Orthopaedic Foot and Ankle Society (AOFAS) hallux-metatarsophalangeal-interphalangeal scale was used for the clinical assessment.

RESULTS: The patients were satisfied following 107 (91%) of the 118 procedures. The mean score on the AOFAS scale was 88.2 ± 12.9 points. The postoperative radiographic assessments showed a significant change (p < 0.05), compared with the preoperative values, in the mean hallux valgus angle, first intermetatarsal angle, distal metatarsal articular angle, and sesamoid position. The valgus deformity recurred after three procedures (2.5%), the first metatarsophalangeal joint was stiff but not painful after eight (6.8%), and a deep infection developed after one (0.8%). The infection resolved with antibiotic therapy.

CONCLUSIONS: The percutaneous technique proved to be reliable for the correct execution of a distal linear osteotomy of the first metatarsal for the correction of a painful mild-to-moderate hallux valgus deformity. The clinical results appear to be comparable with those obtainable with traditional open techniques, with the additional advantages of a minimally invasive procedure, a substantially shorter operating time, and a reduced risk of complications related to surgical exposure.

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Related articles in JBJS:

Percutaneous Distal Metatarsal Osteotomy for Correction of Hallux Valgus

Bruno Magnan, Lorenzo Pezzè, Nicola Rossi, and Pietro Bartolozzi
JBJS 2005 87: 1191-1199. [Abstract] [Full Text]  

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