Our Experience with Double Metatarsal Osteotomy in the Treatment of Hallux Valgus

Abstract

Adolescent hallux valgus (HV) is a progressive deformity of adolescent age consisting of metatarsus primus varus and hallux valgus. It has a high recurrence rate after conventional surgical correction. Ten feet in nine patients (two males, seven females) were treated surgically with the Peterson Newman bunion procedure, with a minimum follow-up of one year. During the final follow-up all these patients had no complaints of pain, joint stiffness or limping. Even though the patients had some mild loss of range of movements at the MTPjoints 4-6 degrees compared to preoperative value, it did not cause any functional impairment and all were satisfied with the final outcome. The double ostetomy for treatment ofhallux valgus is technically precise procedure, provides excellent correction and stability and has low rate of recurrence of deformity. We had an excellent outcome in 10 feet in our study without residual deformity or complications.

Double First Metatarsal and Akin Osteotomy for Severe Hallux Valgus

“…Our results mirror those reported by other authors on series of double first metatarsal osteotomies. 2,8,14,21,24,26,30,35,40 These have been, broadly speaking, of 3 types: a basal opening wedge with a distal closing wedge osteotomy, 2,21,30,40 a basal crescentic or opening wedge cuneiform osteotomy with a distal closing wedge, and a basal modified Mau and a distal Reverdin osteotomy. 35 We believe that this technique offers advantages over those described previously.…”

Proximal Opening Wedge Osteotomy With Distal Chevron Osteotomy of the First Metatarsal for the Treatment of Moderate to Severe Hallux Valgus

“…Although first metatarsal lengthening seems more likely after isolated basal opening wedge first metatarsal osteotomy, shortening might occur in cases of double osteotomy. In cases of substantial lengthening, * References 1,3,9,10,15,17,18,21,28,29. hallux MTP joint overload and reduced ROM or even hallux MTP joint subluxation may arise. 28 In our study, no substantial first metatarsal lengthening or shortening was seen after double first metatarsal osteotomy, and ROM of the first MTP joint tended to be satisfactory.…”

Radiographic evaluation of congruency of the first metatarsophalangeal joint in hallux valgus

“…For patients with hallux valgus of the same degree, there are large differences in the choice of surgical methods due to the existence of MTP joint congruency and incongruency. For example, double metatarsal osteotomy (DMO) is often required for patients who have a large hallux valgus angle (HVA) and congruency of the MTP joint [ 4 , 5 ]. For patients with moderate-to-severe hallux valgus with incongruency metatarsophalangeal joints, scarf osteotomy or simple Chevron osteotomy is effective [ 6 , 7 ].The previous literature used mostly the congruency or incongruency metatarsophalangeal joint as an index to evaluate the effect of hallux valgus surgery [ 8 – 10 ], and its measurement rests only on the arc ratio of the articular surface; however, there is no quantitative measurement index for the congruency of the first MTP joint [ 11 ].…”