Surgical treatment of severe valgus deformity of the first finger of foot for adults

Authors

  • Dmytro Prozorovskiy Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-0469-747X
  • Ruslan Buznytskiy Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Kostiantyn Romanenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-1639-8274

DOI:

https://doi.org/10.15674/0030-598720221-243-48

Keywords:

Treatment of hallux valgus, corrective osteotomy of the first metatarsal bone, corrective arthrodesis of the first metatarsal sphenoid joint, Lapidus arthrodesis

Abstract

Treatment of static deformations of the forefoot with valgus deformation of the first toe remains relevant today. Objective. To
analyze the results of surgery with severe hallux valgus using corrective proximal wedge-shaped osteotomy of the I metatarsal
bone and corrective Lapidus arthrodesis. Methods. The results of surgical treatment of 104 women (147 feet) with severe hallux
valgus according to the Mann classification were evaluated. Age — 27‒65 years, follow-up period — from 10 months up to
5 years. Performed: 65 (56.0 %) cases — corrective proximal wedge-shaped osteotomy of the first metatarsal bone with fixation
with LCP-plate or screws; 51 (44.0 %) — corrective arthrodesis of the first metatarsal-sphenoid joint with LCP-plate
fixation. All patients underwent Schede operation and lateral release of the 1st metatarsophalangeal joint capsule with tenoadductorotomy. The results of treatment were evaluated on the basis of X-ray data and the AOFAS scoring scale. Results.
After osteotomy of the I metatarsal bone in 58 (89.2 %) patients, the treatment result was classified as good, in 7 (10.8 %) — satisfactory. The improvement of the average score was 42 points. After the application of Lapidus arthrodesis, the treatment result was good in 47 (92.2 %) cases, satisfactory in 4 (7.8 %), improvement of the average score was 40 points. Conclusions. Under the conditions of surgical treatment of hallux valgus, the proximal corrective wedge-shaped osteotomy of the first metatarsal bone should in some cases be combined with the distal corrective osteotomy of the first metatarsal bone due to the increase in the PASA angle. The Lapidus arthrodesis technique allows to minimize possible relapses of the deformity, in contrast to traditional corrective osteotomies of the first metatarsal bone due to the formation of ankylosis of the metatarsal sphenoid joint, but has longer consolidation periods and risks of non-union.

Author Biographies

Dmytro Prozorovskiy, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, PhD in Traumatology and Orthopaedics

Ruslan Buznytskiy, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, PhD in Traumatology and Orthopaedics

Kostiantyn Romanenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

Kharkiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine

MD, PhD in Traumatology and Orthopaedics

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How to Cite

Prozorovskiy, D. ., Buznytskiy, R. ., & Romanenko, K. . (2023). Surgical treatment of severe valgus deformity of the first finger of foot for adults. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1-2), 43–48. https://doi.org/10.15674/0030-598720221-243-48

Issue

No. 1-2 (2022)

Section

ORIGINAL ARTICLES

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