Open arthrodesis of hallux associated with percutaneous surgery of metatarsals and minor fingers in antepie severe deformities

Abstract

Objective: To evaluate the functional results and radiographic of the arthrodesis metatarsal-falángica of the hallux by means of open surgery associated with percutaneous surgery of the lesser toes and metatarsals, in the treatment of deformities, severe-forefoot. Methods: We evaluated 16 feet of 12 patients who underwent arthrodesis open hallux more correction percutaneous metatarsal and lesser toes. Were 8 hallux valgus severe, 2 hallux rigid grade III, 3 hallux valgus recidivados post, 1 sequel of surgery keller, 2 hallux varus, severe. Operated from December 2010 until December 2012. All of the female sex. The average age was 61 years. The average follow-up was 34 months. The interventions were performed by the same surgical team. The gestures surgical that were performed were: arthrodesis open hallux approach with a medial placed screw cross plate and dorsal and technical MY in rays minor. Corrected all the deformities in the surgical procedure. At the end of the follow-up survey AOFAS, measurements of x-ray parameters and questionnaire Benton Weil. Results: The score AOFAS pre-op was a 23 point average for the evaluation of the hallux and 29 for the evaluation of the metatarsal and the lesser toes. At the end of the follow-up to the Score for hallux improved to 75 points on average with a range of 53-82. The score for metatarsal and lesser toes was 80 points on average with a range from 53-92. The differences were statistically significant (p less than 0.01). We recorded 1 case of superficial infection that was resolved with ATB mouth. All of the arthrodesis consolidated in an average time of 8 weeks. No recurrence of hallux valgus or claw toes, 2 cases of hyperkeratosis plant central that were resolved 1 with templates (be asymptomatic), and 1 retoco surgically and 1 for screw removal, crossed by irritate the skin. 100% of patients would operate again. Conclusion: We conclude that this association of procedures is a significant contribution to the corrective surgery of the forefoot. These two techniques should not be conflicting: on the contrary, they should complement and be used criteriosamente, still an excellent option and very useful to the association in the management of the patient with deformity severe forefoot.