Vega FE

Language: Spanish
References: 23
Page: 40-49
PDF size: 229.79 Kb.

ABSTRACT

Objective: Evaluate clinical and radiological results obtained with the combination of the first metatarsal osteotomy proximal and distal soft release according Mann-Coughlin technique in the treatment of moderate to severe hallux valgus parts.
Methods: A retrospective study was conducted on 16 patients (30 feet) with hallux moderate and severe valgus. They underwent surgery at two Comprehensive Diagnostic Centers in Apure State, in the Bolivarian Republic of Venezuela, by the same surgeon from March 2009 to December 2012. Only four patients did not continue to follow up. Clinical and radiographic results were evaluated.
Results: an average of 87.5 points improvement was found according to the scale of the American Society of Orthopaedic Foot and Ankle (AOFAS for its acronym in English). The hallux valgus angle improved from 34.8° to 16.6° and average intermetatarsal angle improved from 16.2° to 8.8° after surgery. There were no hallux varus. Only two patients had dehiscence of the surgical wound, and a patient had loosening of the Kirschner needle.
Conclusions: the proximal osteotomy of the first metatarsal combined with distal soft tissue release is a good choice for surgical correction in the treatment of moderate to severe hallux valgus, it is easy to reproduce and it has similar complications than other techniques.

REFERENCES

1. Álvarez Cambras R. Tratado de cirugía ortopédica y traumatología: Ortopedia. La Habana: Editorial Pueblo y Educación; 1986. T2: 178-87.

2. Fleites Lafont LM, Marrero Riverón LO, Lara Valdivia JE, Fortún Planes P, Martínez González M, Jiménez Hernández M, et al . Tratamiento quirúrgico del hallux valgus por la técnica de Lelièvre modificada: Surgical treatment. Rev Cubana Ortop Traumatol [revista en la Internet]. 2009 Jun [citado 2014 Jul 13];23(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864- 215X2009000100004&lng=es .

3. Mann RA, Rudicel S, Graves SC. Repair of hallux valgus with a distal softtissue procedure and proximal metatarsal osteotomy; a long term follow-up. J Bone Joint Surg Am. 1992;74:124-29.

4. Richardson EG, Donley BG. Trastornos del dedo gordo del pie. En: Canale ST Campbell. Cirugía ortopédica. V 4. 10 ed. Madrid: Harcout Brace; 2003. 3915-4010.

5. Díaz Fernández R. Tratamiento del hallux valgus moderado y severo mediante doble osteotomía percutánea del primer metatarsiano. Rev Esp Cir Ortop Traumatol. 2015;59(1):52-8.

6. George HL, Casaletto J, Unnikrishnan PN, Shivratri D, James LA, Alfie Bass, Bruce CE. Outcome of the scarf osteotomy in adolescent hallux valgus. J Child Orthop. 2009;3:185-90.

7. Labrado Berea GC, Marrero Riverón LO, García Estrada EM, Remón Dávila XJ, Roché Egües HE, Guzmán Vázquez M, et al. Influencia de la corrección del metatarso primo varo en la cirugía del hallux valgus. Rev Cubana Ortop Traumatol. 2003;17(1-2):57-61.

8. Robinson AHN, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 2005;87(8):1038-45.

9. Wester JU, Hamborg-Petersen E, Herold N, Hansen PB, Froekjaer J. Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity – A prospective comparative study. Foot Ankle Surg.2015;21(1):1-15. doi: http://dx.doi.org/10.1016/j.fas.2015.04.006

10. Glazebrook M, Copithorne P, Boyd G, DanielsT, Lalonde KA, Francis P, Hickey M. Proximal Opening Wedge Osteotomy with Wedge-Plate Fixation Compared with Proximal Chevron Osteotomy for the Treatment of Hallux Valgus. J Bone Joint Surg Am. 2014;96:1585-92.

11. Mittag F, Leichtle u, Meisner C, Ipach I, Wülker N, Wünschel M. Proximal metatarsal osteotomy for hallux valgus: an audit of radiologic outcome after single screw fixation and full postoperative weightbearing. Journal of Foot and Ankle Research. 2013;6:22.

12. Chuckpaiwong B. Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus. International Orthopaedics (SICOT). 2012;36:2275-8.

13. Jones C, Coughlin M, Petersen W, Paletta J. Mechanical comparison of two types of fixation for proximal first metatarsal crescentic osteotomy. Foot Ankle Int. 2005 May;26(5):371-4.

14. Morris J, Ryan M. First Metatarsal Base Osteotomies for Hallux Abducto Valgus Deformities. Clin Podiatr Med Surg. 2014;31:247-63.

15. Mann RA, Coughlin MJ. Adult hallux valgus. In: Coughlin MJ, Mann RA, eds. Surgery of the foot and ankle. Vol. 1. 7th ed. St. Louis: Mosby Inc., 1999;150–269.

16. Veri JR, Pirani SP, Claridge R. Crescenitic proximal metatarsal osteotomy for moderate to severe hallux valgus: a mean 12.2 year follow-up study. Foot Ankle Int.2001;22:817–22.

17. O’Donnell T, Hogan N, Solan M, Stephens MM. Correction of severe hallux valgus using a basal chevron osteotomy and distal soft tissue release. Foot and Ankle Surgery.2010;16:126-31.

18. Valles Figueroa JFJ, Rodríguez Reséndiz F, Caleti del Mazo E, Malacara Becerra M, Suárez Ahedo CE. Osteotomía metatarsiana distal percutánea para corrección del hallux valgus. Acta Ortopédica Mexicana. 2010;24(6):385-9.

19. Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int. 2007 Jul;28(7):759-77.

20. Mann RA. Distal soft tissue procedure and proximal metatarsal osteotomy for correction of hallux valgus deformity. Orthopedics. 1990,13:1013–1018.

21. Coughlin MJ, Smith BW. Hallux valgus and first ray mobility. Surgical technique. J Bone Joint Surg Am. 2008 Oct;90(Suppl 2):153-70.

22. Ortiz Carrellán F, Mena-Bernal Escobar R, Downey Carmona J, Angulo Gutiérrez J, Melini de Paz F. Tratamiento del hallux valgus con osteotomía basal metatarsal y falángica fijada con placa. Rev. S. And. Traum. y Ort. 2001;21(1):104-109.

23. González López JJ, Rodríguez Rodríguez S, Cadena Méndez C. Resultado funcional, estético y radiográfico del tratamiento quirúrgico del hallux valgus con cirugía mínima invasiva. Acta Ortopédica Mexicana.2004;18(5):185-190.