A New Intramedulary Locking Plate for the Osteotomy of the V. Metatarsal in the Correction of the Tailors Bunion. Midterm Results of 21 Patients

Abstract

Background: Since we are very successful in the operation of hallux valgus using a transverse subcapital osteotomy fixated with an intramedullary angle-stable locking plate, and a tailors bunion is understood as a reversed hallux valgus, we have applied the operation also for such indication. Method: The osteotomy was carried out at a straight V. metatarsal subcapitally, and in case of an outwardly curved V. metatarsal at the bending location. The intramedullary plates are available in different designs and the plate and screws disappear completely in the bone, so the soft tissues are not disturbed. The head of the plate is either straight or curved in order to shift the distal fragment sufficiently. Results: 26 patients were operated within a period of 5 years (2008-2012). 21 patients were followed up after an average of 34.4 months. The IM angle IV/V could be improved by an average of 11.76 to an average of 4.10. This is a highliy significant pre-to postoperative difference of 7.66 (t = 15.07, p < 0.001). The AOFAS score was improved by an average of 42.24 points from 55.76 points preoperatively to 98.00 points postoperative. There was no pseudoarthrosis and no wound healing impairment. All patients were either satisfied or very satisfied with the surgery. Conclusion: This method does not have the disadvantages of the other common operations of the Tailors bunion and is applied now as a standard method in this deformity.