Avaliação do ângulo intermetatarsal após a artrodese da primeira articulação metatarsofalangeana para tratamento do hálux valgo

Abstract

Objective: To evaluate the correction of the intermetatarsal angle after arthrodesis of the metatarsophalangeal joint of the hallux. We believe that varus deformity of the first metatarsal can be corrected after arthrodesis of the first metatarsophalangeal joint, without the need for proximal osteotomy. Methods: Forty-three feet of patients who had undergone arthrodesis of the first metatarsophalangeal joint between May 1997 and October 2009 were retrospectively analyzed by means of radiographs. The mean length of follow-up was 58 months. Measurements on the metatarsophalangeal angle, intermetatarsal angle and sesamoid dislocation were made using radiographs made before, immediately after and later on after the operation. The authors declare that there was no conflict of interest in conducting this work This article is available online in Portuguese and English at the websites: www.rbo.org.br and www.scielo.br/rbort angle was 37.6 degrees preoperatively, 12.8 degrees immediately after the operation and 16.4 degrees later on after the operation. The mean intermetatarsal angle was 16 degrees preoperatively, 10 degrees immediately after the operation and 10.2 degrees later on after the operation. Regarding sesamoid dislocation, preoperative radiographs showed most feet to be classified as G3; immediately after the operation, most were classified as G2; and later on after the operation, most were G1. Conclusion: The intermetatarsal angle and sesamoid dislocation improved with arthrodesis of the first metatarsophalangeal joint, without the need for osteotomy at the base of the first metatarsal.

Sesamoid complex angle correction after arthrodesis of the first cuneometatarsal joint in the treatment of hallux valgus

“…Medimos o ângulo metatarsofalangiano ou de valgismo do hálux (AVH), o ângulo entre o primeiro e o segundo metatarsos (AIM) e a posição dos sesamoides (luxação dos sesamoides) utilizando critérios preconizados pela American Orthopaedic Foot & Ankle Society (14,15) em que os pontos de referência para o primeiro e o segundo metatarsos foram colocados a um centímetro da superfície articular proximal e distal no centro da diáfise, e para a falange proximal de 0,5 cm da superfície articular proximal e distal, conforme figura 1.…”

“…A luxação dos sesamoides foi avaliada pela posição do sesamoide tibial em relação ao eixo mecânico do primeiro metatarsiano, sendo dividida em 4 graus, de acordo com a classificação de Smith (14,16) .…”