Basal osteotomy with lateral soft tissue release and medial plication in the correction of moderate to severe hallux valgus

Anjum, Syed Neshat; Denolf, Frans

doi:10.1016/j.fas.2005.09.001

Foot and Ankle Surgery

2006

DOI: 10.1016/j.fas.2005.09.001

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Basal osteotomy with lateral soft tissue release and medial plication in the correction of moderate to severe hallux valgus

Syed Neshat Anjum¹,

Frans Denolf²

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“…Transfer metatarsalgia, a common complication of HV, often occurs postoperatively because of shortening of the first metatarsal. 1,4 We think that the direction of the osteotomy is very important for performing a Mitchell's osteotomy. Dorsiflexion of the metatarsal head and excessive shortening of the metatarsal should be avoided.…”

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Mitchell’s Osteotomy for Hallux Valgus

Li¹,

Chen²,

Aubeeluck³

et al. 2013

Foot Ankle Int.

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We read with great interest your recent publication of the article by Kalender et al. 3 In their retrospective study, these authors used mini-plate and screw to stabilize the first metatarsal osteotomy in patients undergoing Mitchell bunionectomy. They concluded that this fixation was a safe alternative method for osteotomy fixation in Mitchell's osteotomy in hallux valgus (HV) surgery. However, there are some concerns regarding their study.First, although the plate fixation could provide stable fixation to avoid cast immobilization and secondary osteotomy displacement, there are some disadvantages with this method. (1) Mini-plates are more expensive than screws.(2) Mini-plates require more soft tissue stripping, thus increasing the invasiveness of the procedure. (3) Mini-plates are more prone to induce soft tissue irritation, such as the extensor hallucis longus tendon. In our opinion, single screw fixation could provide sufficiently stable fixation and avoid the above disadvantages. Huang et al 2 used multipleuse compression screws to fix the first metatarsal osteotomy in 95 patients (137 feet) who underwent Mitchell's osteotomy to correct HV. The patients were allowed to walk with special shoe insole on the day after surgery. The stabilization was satisfactory, and no serious complications occurred.Second, Kalender et al didn't mention whether the distal soft tissue was released when they performed Mitchell's osteotomy to correct HV. We would like to know the indications for an additional distal soft tissue release. In our opinion, in some selective cases, soft tissue release (modified McBride procedure) combined with osteotomy can give a better result. The soft tissue procedures can reposition the displaced sesamoids and avoid recurrence of the deformity.

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confidence: 99%

Mitchell’s Osteotomy for Hallux Valgus

Li¹,

Chen²,

Aubeeluck³

et al. 2013

Foot Ankle Int.

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Anatomy of the Plantarmedial Hallucal Nerve in Relation to the Medial Approach of the First Metatarsophalangeal Joint

et al. 2009

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Basal osteotomy with lateral soft tissue release and medial plication in the correction of moderate to severe hallux valgus

Cited by 2 publications

References 8 publications

Mitchell’s Osteotomy for Hallux Valgus

Mitchell’s Osteotomy for Hallux Valgus

Anatomy of the Plantarmedial Hallucal Nerve in Relation to the Medial Approach of the First Metatarsophalangeal Joint

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