Proximal osteotomy of the first metatarsal

results in moderate and severe hallus valgus

Abstract

Objective: To present the mild to severe hallux valgus treatment results with an open wedge proximal osteotomy of the first metatarsal, stabilized with a Normed® plate, in Clínica Santa María from January 2010 to November 2011. Methods: Retrospect revision of a series of cases. Revision to clinical data in patients operated by two surgeons (HAZ, SFC). Same surgical technique in all 65 patients, 99 feet; pre op X rays in 56 and last control in 70 feet. Clinical evaluation at six weeks, three, six and twelve months, considering pain free walking distance, shape, standard shoe wear and satisfaction (K Johnson). IMA and HV angles were considered to evaluation. All complication mwas recorded. Results: Mean follow up to 6,5 months (1 - 23). Pre op IMA: 15º (10º - 23º). Post op IMA: 4.5º (-7º - 12º). Pre op HV angle: 26º (13º - 48º). Post op HV angle: 13º (-6º - 35º). Standard shoe wear change from 40 patients in pre op to 48 patients in post op over 74 patients. Satisfaction with K. Johnson scale was: Satisfied without restrictions: 45 feet, satisfied with minor restrictions: 22 feet, satisfied with mayor restrictions: 6 feet, unsatisfied: 4 feet. Complication were recorded in 13 feet considering hallux varus in 2 feet, persistent pain in 2 feet and need to hardware removal in 9 feet. Conclusions: The present technique shows acceptable results and allows us to consider it as a valid solution to mild to severe hallux valgus