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

Braito, Matthias; Dammerer, Dietmar; Hofer-Picout, Philipp; Kaufmann, Gerhard

doi:10.1177/1071100718799079

Cited by 13 publications

(8 citation statements)

References 30 publications

(61 reference statements)

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“…Kaufmann et al conducted a study with a large case series consisting of 524 patients and demonstrated that there was correction loss after month 3 following chevron osteotomy [24] . In a recent study conducted on 36 patients, Braitoet al applied POWO and DCO procedures together and they reported high complication rates although this approach was highly successful in correcting the deformity [25]. One of the strengths of this study was the comparison of patients included in the study in accordance with the inclusion and exclusion criteria with patients who had similar demographic and clinical characteristics.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Proximal Opening-Wedge Osteotomy and Distal Chevron Osteotomy in the Treatment of Moderate Hallux Valgus Deformity

Akkaya¹

2019

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Introduction: Hallux valgus (HV) deformity is a condition with gradually increasing prevalence, often accompanied by cosmetic deformity. The change in pain and functional levels of patients after surgery directly affects the clinical outcomes in moderate hallux valgus deformities. Aim: The aim of this study was to compare the clinical outcomes of proximal opening-wedge osteotomy and distal chevron osteotomy in the treatment of moderate hallux valgus deformity. Materials and Methods: 37 patients aged between 55 and 65, who were diagnosed with moderate hallux valgus deformity between March 2015 and December 2017 in Ankara Yıldırım Beyazit University YenimahalleTraining and Research Hospital were enrolled in this study. Patients who underwent proximal opening-wedge osteotomy (POWO) were assigned to Group 1 (n=19) and patients who underwent distal chevron osteotomy (DCO) were assigned to Group 2 (n=18). There was no difference between the groups in terms of age, duration of follow-up, demographic and radiological parameters. Visual Analogue Scale (VAS) and American Orthopedic Foot and Ankle Score (AOFAS) systems were used to compare the preoperative period with months 3, 6 and 12. Results: There was a significant difference between the two groups in terms of VAS and AOFAS scores at months 3 and 6 in favor of Group 2 (p<0.001). According to the follow-up at month 12, the change in VAS (p=0.518) and AOFAS (p=0.119) measurements was not statistically significant for any of the groups. Both groups exhibited a statistically significant increase in the scores at months 3 and 6 as compared to the preoperative period. Conclusion: Proximal opening-wedge osteotomy was found to be more effective than distal chevron osteotomy in terms of short-term pain and functional scores in the treatment of moderate hallux valgus deformity. On the other hand, it was seen in follow-ups that both methods alleviated pain and provided similar improvement from the functional aspect.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Proximal Opening-Wedge Osteotomy and Distal Chevron Osteotomy in the Treatment of Moderate Hallux Valgus Deformity

Akkaya¹

2019

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“…A recent randomized controlled trial pointed out no statistically significant differences between MIIND and Reverdin-Isham percutaneous osteotomy in the treatment of mild to moderate HV, providing both good to excellent outcomes. 21 However, distal metatarsal osteotomies, 10,19,47-49 particularly the intra-articular ones, such as Reverdin-Isham, 3,6 can lead to a greater risk of I-MTPJ stiffness, probably due to the need to perform LR. On the contrary, the MIIND, applied after an extra-articular osteotomy and without LR, reduces this risk.…”

Section: Discussionmentioning

confidence: 99%

Functional and Radiographic Outcomes of Minimally Invasive Intramedullary Nail Device (MIIND) for Moderate to Severe Hallux Valgus

et al. 2020

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Background: This study was aimed at assessing clinical and radiographic outcomes of the Minimally Invasive Intramedullary Nail Device (MIIND) to correct moderate to severe hallux valgus (HV) and the long-term persistence of its effects. Methods: This case series study involved 100 patients, 84 women and 16 men (mean age, 59 years), who underwent the MIIND procedure with a mean follow-up of 97 months. Assessment was performed preoperatively, postoperatively, at 6 and 12 months, and at last follow-up. Clinical outcomes were evaluated with American Orthopaedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS), and patient satisfaction. Intermetatarsal angle (IMA), metatarsophalangeal hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and tibial sesamoid position were assessed. Statistical analysis was performed. Results: The mean AOFAS score improved from 57.9 to 90.5 points, VAS scale was 1.5 ± 2.0, and patients’ satisfaction was 8.7 ± 1.4. The mean correction of the HVA and IMA showed a significant correction; however, the effect of time was not statistically significant on DMAA. Sex ( P = .047), severity ( P = .050), associated procedures ( P = .000), and preoperative angle ( P = .000) showed significant association with HVA correction and its persistence over time. Age was not statistically significant. Complications were 9 cases of superficial wound infection and 6 recurrences. Conclusions: The MIIND technique proved a viable procedure to correct moderate to severe HV with a low rate of complications and recurrence, producing significant correction of most radiographic parameters assessed and their persistence, even at long term. Level of Evidence: Level IV, case series study.

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“…Among the 130 described procedures, there is no true consensus and the optimal technique has not been determined. The incorrect orientation of the articular surface of the 1 st metatarsal in juvenile hallux valgus leads us to recommend mainly techniques with osteotomy of the M1 base or cuneiform bone combined with osteotomy of the neck of the 1 st metatarsal to reorient the articular surface 35 . In the literature, a Scarf osteotomy combined as needed with an osteotomy of the 1 st phalanx (Akin 34 ) and a Chevron-type osteotomy of the neck of the 1 st metatarsal have been described extensively.…”

Section: 1mentioning

confidence: 99%

Forefoot malformations, deformities and other congenital defects in children

Rampal¹,

Giuliano²

2020

Orthopaedics & Traumatology: Surgery & Research

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

Cited by 13 publications

References 30 publications

Clinical Outcomes of Proximal Opening-Wedge Osteotomy and Distal Chevron Osteotomy in the Treatment of Moderate Hallux Valgus Deformity

Clinical Outcomes of Proximal Opening-Wedge Osteotomy and Distal Chevron Osteotomy in the Treatment of Moderate Hallux Valgus Deformity

Functional and Radiographic Outcomes of Minimally Invasive Intramedullary Nail Device (MIIND) for Moderate to Severe Hallux Valgus

Forefoot malformations, deformities and other congenital defects in children

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