Distal Linear Osteotomy Compared to Oblique Diaphyseal Osteotomy in Moderate to Severe Hallux Valgus

Abstract

Our study found that distal linear osteotomy was a more reliable reconstruction with equivalent function outcomes than an oblique diaphyseal osteotomy. Additional fixation may be necessary to decrease sagittal malunion in distal Bösch osteotomy.

Supplementary medial locking plate fixation of Ludloff osteotomy versus sole lag screw fixation: A biomechanical evaluation

“…Our findings that the lateral angle change was significantly greater in the two lag screw fixation group throughout the test, even in the unloaded specimes, can be correlated with the reported early loss of first intermetatarsal correction (Chiang et al, 2012;Robinson et al, 2009). Another finding in our study is that supplementary fixation with a locking plate leads to a significantly greater resistance to the lateral angle change.…”

“…Significant loss of correction of the intermetatarsal angle early in the postoperative period has been reported (Robinson et al, 2009), and it is interesting that in one study led to a recurrence in 26,7% of the patients (Chiang et al, 2012). Malunion requiring revision has also been observed with a reported incidence of 1.5 % to 5%.…”

“…A C C E P T E D M A N U S C R I P T 4 union is a well described complication with an incidence of 2%-6,7% (Chiang et al, 2012;Chiodo et al,2004;Robinson et al, 2009;Trnka et al, 2008). Significant loss of correction of the intermetatarsal angle early in the postoperative period has been reported (Robinson et al, 2009), and it is interesting that in one study led to a recurrence in 26,7% of the patients (Chiang et al, 2012).…”

“…A number of proximal (Chow et al, 2008;Easley et al, 1996;Gallentine et al, 2007;Trnka et al, 1999) and diaphyseal (Chiodo et al, 2004;Robinson et al, 2009;Trnka et al, 2008) osteotomies have been utilized for the correction of moderate and severe hallux valgus deformities, but there are several issues regarding their mechanical instability, inadequate fixation and reduced healing potential which might lead to delayed union, dorsal malunion, or fixation failure with subsequent loss of correction (Chiang et al, 2012;Easley et al, 1996;Robinson et al, 2009;Trnka et al, 1999). The Ludloff diaphyseal oblique osteotomy (Chiodo et al, 2004;Robinson et al, 2009;Saxena, McCammon., 1997;Trnka et al, 2008) seems to be the most commonly used osteotomy (Pinney et al, 2006) (among foot and ankle surgeons in USA) for the correction of severe hallux valgus deformity.…”

“…This instability inevitably leads to irritation callus formation at the osteotomy site with a reported incidence of 16% to 26,7% (Chiang et al, 2012;Trnka et al, 2008). Delayed…”