Opening wedge osteotomy of the first cuneiform for the treatment of hallux valgus

Jawish, Roger; Assoum, Hani; Saliba, Élie

doi:10.1007/s00264-009-0825-y

Cited by 16 publications

(9 citation statements)

References 32 publications

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“…However, 11% of our patients developed arthritic changes at the MTP joint postoperatively and more than 60% of those feet with preexisting radiological signs of arthritis demonstrated a distinct worsening of degenerative changes. Since comparable results have been known even from open-wedge osteotomies of the cuneiform, the development of arthritis does not seem to be specific to metatarsal osteotomies [10].…”

Section: Discussionmentioning

confidence: 64%

Mid-term results of Scarf osteotomy in hallux valgus

Fuhrmann

Zollinger-Kies

Kundert

2010

International Orthopaedics (SICOT)

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We performed a retrospective study on 178 Scarf osteotomies with a mean follow-up of 44.9 months (range 15-83 months). Clinical rating was based on the forefoot score of the American Orthopaedic Foot and Ankle Society (AOFAS). Weight bearing X-rays were used to perform angular measurements and assess the first metatarsophalangeal joint (MTP 1). At follow-up the mean AOFAS score had improved significantly (p<0.001), but only 55% of the feet showed a perfect realignment of the first ray. Patients with a hallux valgus angle exceeding 30°and preexisting degenerative changes at the MTP 1 joint displayed inferior clinical results (p<0.05). Nearly 20% of the patients suffered from pain at the MTP 1 joint. This was clearly attributed to an onset or worsening of distinct radiographic signs of arthritis (p<0.05) resulting in painfully decreased joint motion. Comparing radiographic appearance three months postoperatively and at follow-up, we found that radiographic criteria (hallux valgus, first intermetatarsal angle, hallux valgus interphalangeus, MTP 1 joint congruency, arthritic lesions at MTP 1) worsened with time.

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Section: Discussionmentioning

confidence: 64%

Mid-term results of Scarf osteotomy in hallux valgus

Fuhrmann

Zollinger-Kies

Kundert

2010

International Orthopaedics (SICOT)

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“…Over 130 different surgical techniques [1][2][3][4] to correct hallux valgus deformity have been proposed, although choosing the most appropriate treatment option continues to generate controversy [5][6][7][8][9][10][11]. The current trend is directed toward percutaneous procedures with the potential benefits of minimally invasive surgery [2], e.g.…”

Section: Introductionmentioning

confidence: 99%

Long-term results of the retrocapital metatarsal percutaneous osteotomy for hallux valgus

Faour-Martín

Martín-Ferrero

García

et al. 2013

International Orthopaedics (SICOT)

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Purpose The current trend in hallux valgus surgery is directed toward percutaneous procedures. However, no evidence that any of these methods of treatment are superior to the others has been described, excepting studies in the long term. The aim of this study was to analyse a series of patients who had undergone a percutaneous distal retrocapital osteotomy of the first metatarsal, and had been followed up for ten years. Methods We carried out a clinical and radiological evaluation of 115 feet ten years after surgery. Results The AOFAS scale results in the tenth postoperative year remained significantly favourable compared to their corresponding values in the preoperative period, yielding an improvement of 42.2 points overall on average. In relation to radiological findings, the mean hallux angle was maintained below 20°, with a mean intermetatarsal angle of 8.1°. Conclusion Percutaneous retrocapital metatarsal osteotomy for treatment of mild to moderate hallux valgus is effective in the long term, with the advantages of a minimally invasive procedure.

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“…A recently published retrospective case series detailed results of medial cuneiform opening wedge osteotomies using an allograft wedge combined with distal soft tissue realignment. 14 The series included 63 patients (101 feet) with an average age of 42 years with varying severity of hallux valgus deformities (4% mild, 54% moderate, and 42% severe). All patients underwent medial cuneiform osteotomy regardless of preoperative radiographic measurements or degree of first TMT joint obliquity.…”

Section: Discussionmentioning

confidence: 99%

Medial Cuneiform Opening-Wedge Osteotomy for the Treatment of Hallux Valgus

Ahuero

Kirchner²,

Ryan

2019

Foot & Ankle Orthopaedics

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Background: While proximal first metatarsal osteotomy combined with distal soft tissue realignment is accepted as standard treatment of moderate to severe hallux valgus with metatarsus primus varus, none of the described proximal metatarsal osteotomies address the hyper-obliquity of the first metatarsocuneiform joint. An opening-wedge osteotomy of the medial cuneiform can potentially correct the 1-2 intermetatarsal angle (IMA) in addition to normalizing the hyperobliquity of the first tarsometatarsal (TMT) joint. The purpose of this study was to retrospectively review the early radiographic and clinical results of the use of a medial cuneiform opening-wedge osteotomy fixed with a low-profile wedge plate combined with distal soft tissue realignment for the treatment of hallux valgus. Methods: Fourteen feet (13 patients; 2 male and 11 female, average age 56 years, range 22-75) with hallux valgus underwent an opening-wedge osteotomy of the medial cuneiform fixed with a low-profile nonlocking wedge plate combined with distal soft tissue realignment. The mean preoperative hallux valgus angle (HVA) was 32 degrees and the IMA was 16 degrees. HVA, 1-2 IMA, proximal first metatarsal inclination (PFMI), and presence of osteoarthritis of the first TMT joint were assessed on preoperative and final postoperative radiographs. Final postoperative radiographs were also evaluated for radiographic union and hardware failure at an average of 7 months (range, 3-19 months) postoperatively. Results: A mean intraoperative correction of 19 degrees and 7 degrees was achieved for the HVA and IMA, respectively. The mean HVA was 22 degrees and the mean IMA was 11 degrees at the time of final follow-up. At final follow-up, a recurrence of the deformity was observed in 12/14 feet. There were 2 nonunions-one plate failure and one screw failure. No first TMT joint instability or arthritis was observed. All patients were ambulatory without assistive device in either fashionable or comfortable shoe wear. Conclusion: Medial cuneiform opening-wedge osteotomy resulted in unreliable correction of HVA and IMA at short-term follow-up with a high rate of early recurrence of hallux valgus deformity and a complication rate similar to that of the Lapidus procedure. This procedure cannot be recommended for addressing hallux valgus in the setting of increased obliquity of the first TMT joint. Level of Evidence: Level IV, case series.

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Opening wedge osteotomy of the first cuneiform for the treatment of hallux valgus

Cited by 16 publications

References 32 publications

Mid-term results of Scarf osteotomy in hallux valgus

Mid-term results of Scarf osteotomy in hallux valgus

Long-term results of the retrocapital metatarsal percutaneous osteotomy for hallux valgus

Medial Cuneiform Opening-Wedge Osteotomy for the Treatment of Hallux Valgus

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