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PubMed1998

[Surgical therapy of hallux valgus in the young and middle-aged female].

OBJECTIVE: To correct hallux valgus in the young or middle-aged female. METHOD: Through dissecting foot specimens with hallux valgus we found that the intrinsic factor that caused hallux valgus was a "capstan" like mechanism of pressure. In order to eliminate the mechanism of the deformity, we cut off the link between the adductoris hallucis and the hallux completely. The tendon of adductoris hallucis was sutured to the fascial flap of hallucis bursa passing through a hole in the caput of the metatarsus. By this way the adductoris hallucis was fixed to the 1st metatarsus strongly, thus it pulled the 1st metatarsus directly. RESULTS: Twenty feet received this operation. 18 feet were followed up for 0.5-4 years. The rate of excellent and good results was 100%. CONCLUSION: This operation by suturing the adductoris hallucis with the fascial flap of the hallucis bursa not only can relieve pain but also restore the normal appearance of the foot.

Adult↗

PubMed1980

Hallux valgus--an acquired deformity of the foot in cerebral palsy.

In this series, acquired hallux valgus deformity occurred in those cerebral palsied children who, when initially seen as prewalkers, had neutral foot alignment and then developed a stance and gait pattern of flexion-adduction at the hips, flexion at the knees, and equinus of the feet, with external torsional effect in the leg below the knee forcing the foot into relative equinovalgus. This resulted in an abducted forefoot manifested primarily as a hallux valgus. The one variation to this premise was the equinovarus heel and adducted forefoot. Here, the resultant thrust was on the lateral border of the foot, and hallux valgus did not occur. In all instances where the response to surgery is incomplete, the foot deformity will develop. Finally, it is noted that a posterior tibial lengthening added to the surgical procedures done for the equinovarus foot has the potential ability in the cerebral palsied child to convert an equinovarus, which does not produce an acquired hallux valgus, into equinovalgus, which does produce this deformity.

Adolescent↗

PubMed2004

[Radiographic and functional results of the Lindgren-Turan operation in the treatment of hallux valgus].

OBJECTIVES: We evaluated the radiographic and functional results of the Lindgren-Turan operation in the treatment of hallux valgus. METHODS: Twenty-nine feet of 25 patients (15 women, 7 men; mean age 42 years; range 20 to 68 years) were treated by the Lindgren-Turan method. Of these, 24 feet with appropriate follow-up were included. Intermetatarsal and hallux valgus angles were measured on preoperative, postoperative, and follow-up anteroposterior radiographs. Pain was evaluated by a visual analog scale. The range of motion of the first metatarsophalangeal joint was measured at the end of follow-ups. The mean follow-up period was 26.5 months (range 6 to 54 months). RESULTS: Postoperatively, the mean corrections were 6.9 degrees and 5.1 degrees in the hallux valgus and intermetatarsal angles, respectively (p<0.05). At the end of the follow-up period, the mean loss of correction was 1.8 degrees for the hallux valgus angle, and 0.5 degrees for the intermetatarsal angle; the mean pain score decreased from preoperative 7.78 to 1.35 (p<0.05) and the mean range of motion of the first metatarsophalangeal joint was 56.8 degrees dorsiflexion and 14.9 degrees plantar flexion. The mean time to return to presurgery activity levels was 44.2 days (range 30 to 70 days). Of the patient group, 83.3% expressed satisfaction with the surgical outcome. Clinical and radiographic evaluations showed excellent results in 15 (62.5%), good in seven (29.2%), and unsuccessful in two patients (8.3%). CONCLUSION: The Lindgren-Turan osteotomy is a preferable method in the surgical treatment of patients with moderate hallux valgus.

Adult↗

PubMed2005

Correlation of hallux valgus surgical outcome with AOFAS forefoot score and radiological parameters.

BACKGROUND: The purpose of the study was to evaluate the effect of three different types of hallux valgus surgeries on patient function using validated questionnaires and to correlate the results with radiographic and physical examinations. This study presents the 2-year followup data of a previous prospective outcome study. METHODS: One hundred and ninety-six patients were enrolled in this study and completed a baseline AAOS Lower Limb Outcomes Data Collection Questionnaire. They completed the same form at 6, 12, and 24 months after having one of three types of hallux valgus surgeries (106 chevron osteotomies, 72 modified McBride procedures, and 18 modified Lapidus procedures). This questionnaire included the Short Form-36 Health Survey (SF-36) as well as questions relating to lower extremity function. Additionally, physicians were asked to complete preoperative and postoperative questionnaires on each patient that included radiographic and physical examination data and the type of surgery done. Completed outcome surveys and radiographic data were available on 196 patients, and physical examination scores were available to assign an AOFAS score in 111 patients at 24-month followup. A one-way comparison was done after stratifying the results for the type of surgery, preoperative hallux valgus angle and 1-2 intermetatarsal angle, postoperative hallux valgus angle and 1-2 intermetatarsal angle, and the change in the angles. RESULTS: Four of the 10 SF-36 scores (physical function, role-physical, bodily pain, and role-emotional) for the combined data improved by more than five points. For the AAOS lower extremity function scores, physical health and pain (68.5 to 81.6), satisfaction with symptoms (1.8 to 3.6), global foot and ankle (77.6 to 93.4), and shoe comfort (29.0 to 58.7) scores all increased significantly. The AOFAS score increased from 52.6 to 85.5 (p <0.001). Surprisingly, when comparing mild-to-moderate to severe deformities preoperatively and postoperatively using the absolute magnitude of the angular change in the hallux valgus or intermetatarsal angles, similar improvement was noted in AOFAS, SF-36, and AAOS lower extremity scores. The magnitude of preoperative deformity, postoperative residual deformity, and magnitude of correction also did not significantly change the amount of improvement in any of these scores. No significant differences were noted in the outcome scores among the three different surgeries. CONCLUSION: Patients who had hallux valgus surgery had significant improvements in four of their SF-36 scores, four of five of AAOS lower extremity scores, and AOFAS scores. The degree of deformity, amount of correction, or type of operation did not influence outcome.

Adolescent↗

PubMed2005

[Scarf osteotomy for the treatment of hallux valgus: a review of 123 cases with 4.8 years follow-up].

PURPOSE OF THE STUDY: Many different osteotomies can be used for the treatment of hallux valgus. The purpose of this study was to evaluate the Scarf osteotomy associated or not with phalangeal osteotomy and to search for deformation cutoff points beyond which corrections appear to be difficult to achieve. MATERIAL AND METHODS: This retrospective analysis included 87 patients (123 feet) among 130 who underwent hallux valgus surgery between October 1993 and November 2000. Mean follow-up was four years eight months. The serie included 83 women and 4 men. Mean age at surgery was 53.5 years. A Scarf diaphyseal osteotomy was performed in all patients associated or not with phalangeal osteotomy. Each patient was reviewed clinically and radiographically with anteroposterior and lateral views of the foot in the standing position. RESULTS: 84.6% of the patients were satisfied or very satisfied. There was a correlation between the index of satisfaction and clinical symptoms (metatarsalgia, stiff hallux, pain over exostosis). There was a statistically significant decrease in hallux valgus (31.2 degrees to 17.5 degrees ), of metatarsus varus (12.1 degrees to 7.5 degrees ), and articular angle of the distal metatarsus (13.3 degrees to 11.1 degrees ). Patients who had phalangeal osteotomy achieved the best hallux valgus correction (15 degrees versus 21.4 degrees ). Mean shortening of the first metatarsus was 2.2 mm with a decrease in the metatarsus-ground angle (19 degrees versus 20.1 degrees ). Cutoff limits for deformations which are difficult to correct satisfactorily were M1M2 angle > or = 15 degrees and distal metatarsal articular angle > or = 13 degrees . The overall Groulier score showed 70.7% very good and good results, 27.6% fair results and 1.7% poor results. DISCUSSION: The Scarf technique is a reliable method to achieve significant correction of hallux valgus deformation. It requires a rigorous technique with specific attention to the elevation of the first metatarsus and excessive shortening, two factors favoring metatarsalgia. Adding a phalangeal osteotomy can improve the radiological result, but it is very difficult to obtain satisfactory correction if the initial deformations are severe and associated. Rotation of the plantar fragment helps for better orientation of the articular surface of the first metatarsus but limits the correction of the metatarsus varus. Function is the basic objective of hallux valgus surgery and patient satisfaction is related solely to clinical symptoms.

Adolescent↗

PubMed1997

Modified Austin procedure for correction of hallux valgus.

The Austin osteotomy is a widely accepted method for correction of mild and moderate hallux valgus. In view of publications by Kitaoka et al. in 1991 and by Mann and colleagues, a more radical lateral soft tissue procedure was added to the originally described procedure. From September 1992 to January 1994, 85 patients underwent an Austin osteotomy combined with a lateral soft tissue procedure to correct their hallux valgus deformities. Seventy-nine patients (94 feet) were available for follow-up. The average patient age at the time of the operation was 47.1 years, and the average follow-up was 16.2 months. The average preoperative intermetatarsal angle was 13.9 degrees, and the average hallux valgus angle was 29.7 degrees. After surgery, the feet were corrected to an average intermetatarsal angle of 5.8 degrees and an average hallux valgus angle of 11.9 degrees. Sesamoid position was corrected from 2.1 before surgery to 0.5 after surgery. The results were also graded according to the Hallux Metatarsophalangeal Interphalangeal Score, and the functional and cosmetic outcomes were graded by the patient. Dissection of the plantar transverse ligament and release of the lateral capsule repositioned the tibial sesamoid and restored the biomechanics around the first metatarsophalangeal joint. There was no increased incidence of avascular necrosis of the first metatarsal head compared with the original technique.

Adolescent↗

PubMed2002

Relation between hallux valgus deformity and lumbar and lower extremity biomechanics.

Hallux valgus (HV) is a static subluxation of the first metatarsophalangeal joint with lateral deviation of the great toe and medial deviation of the first metatarsal. Our aim was to evaluate the interference of HV deformity with changes in lumbar lordosis and some foot deformities. Twenty HV patients and 20 healthy subjects were selected for the study. Hallux valgus angle, metatarsus primus varus (MPV), metatarsus omnis varus (MOV), first intermetatarsal (1.IMT), second metatarsal (2. MT) and hallux interphalangeal (HIP) angles were estimated from the anteroposterior foot X-rays. Lumbosacral (LSA) and sacrohorizontal angles (SHA) were measured from lateral lumbar x-rays and pes planus was detected from lateral and anteroposterior ankle and foot radiographs. There was a significant difference between HV angle mean values of two groups. MPV, MOV, 1.IMT, 2. MT and HIP angles did not show significant difference between groups. HV angle was found to be correlated with MPV. HIP angle was found to be correlated with LSA and SHA, indicating a relation with lordosis. HV and pes planus were correlated with each other. HV also showed weak correlation with hyperlordosis. Transmission of variations in body mechanics through pelvis and lower extremity plays an important role for certain foot deformities. Some factors affecting HV development are correctable; early diagnosis and treatment of MPV and pes planus, suggesting healthy rather than fashionable footwear and preventing obesity may lower HV incidence.

Adult↗

PubMedDate not supplied

[Early outcome of correction of hallux valgus with the Scarf osteotomy].

INTRODUCTION: Aim of this study is to analyze complications as well as clinical and radiological results of the scarf osteotomy for the correction of hallux valgus. PATIENTS AND METHODS: Between 1994 and 1998 we performed a scarf osteotomy for the correction of hallux valgus in 45 cases. Indication was a symptomatic hallux valgus with an increased first intermetatarsal angle (IMA). Fixation of the osteotomy was performed with two 2.3 mm mini screws made of titaneum. Mobilisation was allowed with full weight bearing with a fore foot relief orthesis. Clinical results were valued with the fore foot scoring system (ffss). The determination of the IMA and hallux valgus angles (HVA) was performed with weight bearing d.p. radiographs. RESULTS: All osteotomies healed within the first 6 postoperative weeks. Removal of the screws was not necessary in any case. The preoperative ffss was 16.2 points. At the last follow up (16 month after surgery) the average value of the ffss was 59.1 points. Three patients reached a value below 35 points, two of them suffered from a rheumatic disease. Twenty patients assessed the cosmetic result as excellent, 16 as good, 4 as satisfactory and one as poor. The average IMA could be reduced significantly from 20.2 to 10.3 degrees. The HVA could be lowered from 37.5 to 20.9 degrees. In patients with an IMA of more than 20 degrees the HVA could be reduced to 23.1 degrees in contrast to 18.3 in patients with an IMA of less than 20 degrees. DISCUSSION: The scarf osteotomiy is a surgical procedure for the correction of hallux valgus due to increased IMA which is appropriate in patients younger than 50 years and older than 50 years. In cases of IMA more than 20 degrees correction of IMA and HVA was unsatisfactory.

Adolescent↗

PubMed1998

Hallux valgus in young patients: comparison of soft-tissue realignment and metatarsal osteotomy.

Two procedures of hallux valgus correction in young patients were compared by long-term results: soft-tissue realignment (McBride) and Mitchell osteotomy. From 1970 to 1990, 33 hallux valgus deformities of 17 patients were corrected with one of these procedures at the Orthopaedic Department of the University of Mainz. Patients' age at operation ranged from 9 to 20 years and average follow-up was 16 years later. Reevaluation consisted of subjective criteria, such as pain, shoe-fitting, functional disability and cosmetics and objective parameters (hallux-valgus and intermetatarsal angle, osteoarthrotic changes and range of motion of the metatarsophalangeal joint). They were assessed by report, interview, radiograph and physical examination and determined the overall outcome. McBride procedure showed 59% good, 12% satisfying and 29% dissatisfying long-term results, whereas outcome after Mitchell osteotomy was graded as good in 69%, satisfying in 12% and dissatisfying in 19% of the cases. Critical analysis emerged, that each procedure has its own bounds of indication. Successful hallux valgus correction can be achieved by an individual approach consisting of careful study of the indications, well-performed surgery and appropriate postoperative care.

Adolescent↗

PubMed2004

Axial radiographic evaluation in hallux valgus: evaluation of the transverse arch in the forefoot.

To quantitatively evaluate the shape of the transverse arch in the forefoot with hallux valgus, a method for axial imaging and analysis of the forefoot has been developed. A foot was imaged at 30 degrees of flexion. A two-dimensional coordinate system was established by drawing a vertical line on the X-ray image through the lowest point of the head of the second metatarsal. The origin was set at the intersection between the plane of the base of the foot and this vertical line. A control group of 51 feet from 29 normal subjects and a test group of 59 feet from 34 subjects with hallux valgus were examined. Compared with the normal group, the heads of the first, second, and third metatarsal bones were lower in the hallux valgus group, and their sesamoids were shifted outward with a rotational deviation. There was a statistical correlation between the degree of outward dislocation of the fibular sesamoid bone and the hallux valgus angle. The position of the fibular sesamoid bone become higher than the head of the first metatarsal when the angle of the hallux valgus exceeded 25 degrees.

Adolescent↗

PubMed1996

Clinical and radiological results after Austin bunionectomy for treatment of hallux valgus.

The results of the Austin osteotomies for hallux valgus deformity performed at the Orthopedic Hospital Gersthof were reviewed at least 1 year after surgery. Of the 53 consecutive patients (66 operations) with an average follow-up of 24.3 months, 49 patients (62 feet) were interviewed. Of the reviewed patients 86.6% achieved good or excellent clinical results. The complication rate was 8%, including hallux varus n (3), superficial n (1) and deep n (1) wound infections, hypoaesthesia n (2), and reflex sympathetic dystrophy n (1). There was one case of avascular necrosis of the first metatarsal head and none of non-union. The Austin osteotomy is a safe and effective treatment of mild and moderate hallux valgus deformity.

Adolescent↗

PubMed2005

[Sagittal mobility study on the first tarsometatarsal joint in hallux valgus patients and its clinical values].

OBJECTIVE: To study sagittal mobility about the FTJ (first tarsometatarsal joint) and its relationship with the pathophysiology and treatment of hallux valgus patients. METHODS: According to Lee's method, FTJ sagittal mobility of 300 normal feet and 200 hallux valgus was measured, and its correlative factors were statistically analysed. RESULTS: FTJ sagittal mobility of 300 normal feet was 8.4 degrees +/- 2.3 degrees , and that of 200 hallux valgus was 11.7 degrees +/- 3.2 degrees , the difference was significant. The normal range of FTJ sagittal mobility was less than 13 degrees . The sagittal overmotion of FTJ had relation to the anatomical configuration of FTJ (P < 0.05), intercuneiform splitting (P < 0.01), transferred pain under the second metatarsal head (P < 0.01), and FTJ osteoarthritis (P < 0.01) had no relation to HVA (hallux valgus angle), IMA (intermetatarsal angle), second metatarsus medial diaphyseal cortex hypertrophy (P > 0.05). CONCLUSION: Lee's method is convenient and accurate. Both HVA and IMA can not represent the sagittal mobility measurement of FTJ, which should be routinely evaluated, especially for hallux valgus patients with type I FTJ. Lapidus procedure should be considered for patients with larger FTJ in combination with transferred pain under the second metatarsal head, intercuneiform splitting, FTJ osteoarthritis.

Adolescent↗

PubMed2000

Scarf osteotomy for correction of hallux valgus. Historical perspective, surgical technique, and results.

The Scarf osteotomy has proven to be a versatile and powerful procedure to correct various degrees of hallux valgus deformity. Through modifications of bone-cut lengths and in combination with a phalangeal osteotomy, most hallux valgus deformities can be addressed. In cases of extreme hypermobility of the first ray or arthrosis of the first metatarsocuneiform joint, the Lapidus operation may be more appropriate. Hallux valgus rigidus or hallux valgus with severe rheumatoid joint disease usually requires alternative procedures. The results of the Scarf osteotomy compare favorably with the results reported for other popular bunion surgeries. When choosing a procedure, the clinician should consider that the Scarf osteotomy allows the patient to ambulate postoperatively without a cast or the use of crutches, to return to bathing and a closed athletic shoe in one week, and to have bilateral surgery, which maintains cost-effectiveness and returns the patient to his or her desired lifestyle more quickly. It has been said that surgery is both a science and an art. The author often believes that bunion surgery is more art than science, hence the success of so many procedures in one surgeon's hands and the failure in another's hands. The Scarf bunionectomy is a technically demanding procedure that has a large learning curve. Once mastered, however, the Scarf bunionectomy can provide a predictable and satisfying outcome for both patient and foot surgeon.

Bone Screws↗

PubMed1997

The Mayday distal first metatarsal osteotomy for hallux valgus: a review after the introduction of a new instrument.

We present the short-term follow-up of 55 symptomatic hallux valgus deformities in 38 patients, treated operatively with a modification of the spike distal first metatarsal osteotomy, as described by Gibson and Piggott in 1962. The age range of the patients was 17 to 72 years at the time of surgery. The postoperative follow-up period was 12 to 55 months. Excellent and good clinical and radiographic results were recorded in 96.2% of our patients. Two of the patients (3.8%) were dissatisfied; one of them complained of metatarsalgia after the procedure, and the other had stiffness of the metatarsophalangeal joint and metatarsalgia that had been present before surgery. Three others (5.45%) required revision after early postoperative displacement but were asymptomatic subsequently. We concluded that our technique is an effective method of treating mild hallux valgus deformities with the advantages of simplicity, no shortening of the first metatarsal, and no risk of dorsal tilting of the distal fragment. Hallux valgus (lateral deviation of the great toe) is not a single disorder, as the name implies, but a complex deformity of the first ray that sometimes may involve the lesser toes. More than 130 procedures exist for the surgical correction of hallux valgus, which means that no treatment is unique. No single operation is effective for all bunions. The objectives of surgical treatment are to reduce pain, to restore articular congruency, and to narrow the forefoot without impairing function, by transferring weight to the lesser metatarsals either by shortening or by dorsal tilting of the first metatarsal. Patient selection is important for a satisfactory outcome after surgery of any kind, and our criteria were age, degree of deformity, presence of arthrosis, and subluxation of the first metatarsophalangeal joint. In this study, we present a new method of treating hallux valgus that has been used at Mayday University Hospital since 1990. The technique was first described at the British Orthopaedic Foot Surgery Society, Liverpool, November 1990, and we now present the short-term follow-up results. The procedure is essentially a modification of the spike osteotomy of the neck of the first metatarsal, as described by Gibson and Piggott. It has the advantages of simplicity, no shortening of the first metatarsal, and no risk of dorsal displacement of the distal fragment.

Adolescent↗

PubMed1996

[Resection arthroplasty in the treatment of hallux valgus].

Sixty-six feet operated on for hallux valgus in 1984 were reviewed. Keller-Brandes' operation was performed in all cases, together with Lelièvre's "fibrous cerclage" and flexor hallucis longus tendon anchoring to the sesamoid pad, as described by A. Viladot. In most cases, satisfactory clinical correction was achieved and the patients could wear standard shoes. More than half of the cases presented partial limitation of movement at the first metatarsophalangeal joint; however, flexion power of the big toe was preserved, and the range of motion was wide enough to allow a painless and limp-free gait. Radiologically, good correction of the angle between the first and second metatarsals and the metatarsophalangeal angle was obtained, but all cases presented proximal displacement of sesamoid bones. A baropodometric study showed that the toe-off phase of the gait does not change after this operation. In our series, central metatarsalgia was present in 17 feet; however, it did not compromise the functional result and was easily relieved with orthopaedic devices. Four feet showed radiographic images, suggesting necrosis of the first metatarsal head; all four were asymptomatic. The only case that required reoperation was the one that developed hallux varus deformity. The Keller-Brandes-Lelièvre-Viladot procedure is still a simple and effective method for the surgical treatment of hallux valgus in elderly people with osteoarthritis at the first metatarsophalangeal joint.

Adult↗

PubMed2004

New modified technique of osteotomy for hallux valgus.

PURPOSE: To improve the technique of osteotomy for hallux valgus (bunion). METHODS: 38 cases of a new modified osteotomy procedure for hallux valgus were performed for 22 patients (21 women and one man). During a 3-year (range, 2-5 years) follow-up, the patients underwent physical examination; and their American Orthopedic Foot and Ankle Society hallux-metatarso-phalangeal-interphalangeal scale scores and standard foot radiographic measurements were recorded. RESULTS: 20 of the 22 patients (38 cases) had no pain, achieved good cosmesis, and were completely satisfied with the results of the operation. The remaining 2 patients had occasional mild discomfort. The mean hallux-metatarso-phalangeal-interphalangeal scale score was 93 points (range, 78-100 points). The mean preoperative and postoperative metatarsophalangeal angles were 34 degrees and 11 degrees, respectively. The mean postoperative reduction of the intermetatarsal angle and metatarsophalangeal angle were 6 degrees and 23 degrees, respectively. CONCLUSION: The new technique of osteotomy achieved even greater stability and accurate correction of the deformity in our 38 cases. Furthermore, it was more effective than conventional 'chevron' osteotomy in terms of correction of the deformity. Therefore, it should be used more widely.

Adolescent↗

PubMed2006

Radiographic angles in hallux valgus: differences between measurements made manually and with a computerized program.

BACKGROUND: The objective of this study was to compare angular measurements in the evaluation of hallux valgus deformities using a goniometer and a computerized program to assess degree of concordance between the two methods and determine the reliability of manual measurements. METHODS: Angles measured included the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the distal metatarsal articular angle (DMAA), and the proximal phalangeal articular angle (PPAA), also called the hallux valgus interphalangeus angle or interphalangeal angle. Measurements were made on preoperative weightbearing radiographs in 176 patients with symptomatic hallux valgus. Manual measurements were made with a goniometer by an orthopaedic surgeon. An independent experienced technician used digitized images to perform angular measurements with the Autocad software program (Autodesk Inc., San Rafael, CA). RESULTS: HVA values obtained with the two techniques were similar. However, significantly higher mean values were obtained with the Autocad for the IMA and PPAA measurements, and higher mean values were obtained for the DMAA measurement with the manual technique. Whereas differences were more or less randomly distributed for the HVA, in the remaining patients, measurements were clearly related to the measurement technique, i.e., for the DMAA, the manual technique had a tendency to show higher values, and for the IMA and PPAA the manual technique showed lower values than the computer. Correlations between both techniques for the different angular measurements were as follows: HVA, -0.179 (p = 0.018); DMMA, -0.294 (p < 0.001); PPAA, -0.876 (p < 0.001); and IMA, -0.661 (p < 0.001). The intraclass correlation coefficient (ICC) showed that the concordance between manual and Autocad angular measurements was excellent for the HVA (ICC = 0.89) and DMAA (ICC = 0.80) and very poor for the PPAA (ICC = 0.11) and IMA (ICC = 0.42). CONCLUSIONS: Angular measurements made on weightbearing radiographs with the Autocad in patients with hallux valgus deformities were more reliable than those made with a goniometer. Although for large angles, such as HVA and DMAA, results obtained with both measurement techniques were similar. Manual measurements, however, may underestimate the true values of the smaller IMA and PPAA angles.

Hallux Valgus↗

PubMed1995

Hallux valgus correction using a modified Hohmann technique.

In 181 patients presenting with hallux valgus (247 toes), we performed a modified Hohmann procedure with Kirschner wire fixation of the osteotomy. Follow-up by a questionnaire was possible in 159 patients representing 217 operated toes (21 reoperations), and roentgenograms of bony healing were assessed in all these patients. The questionnaire was returned by 91% (145/159) of the patients. The average observation time was 52 months (25-97 months). The average correction of the hallux valgus angle was 10 degrees, ranging from 31.4 degrees before surgery to 21.4 degrees after surgery. Eighty-eight percent of the patients stated that they had an excellent or good/fair result, and 12% had pain or problems with footwear. We found a positive correlation among the correction of the valgus angle, the lateral displacement, shortening of the first metatarsal, and the overall result. No correlation was found among the plantar displacement, correction of the intermetatarsal angle and the result. The modified Hohmann procedure is, in our opinion, a safe and reliable procedure for treating hallux valgus deformity of the foot.

Adolescent↗