title: The first metatarsal bicorrectional head osteotomy (distal "L"/Reverdin-Laird procedure) for correction of hallux abducto valgus: a retrospective study.
abstract: A retrospective analysis of the distal "L" osteotomy with bunionectomy (Reverdin-Laird procedure) for correction of hallux abducto valgus was performed. Sixty-nine cases meeting strict eligibility and exclusion criteria underwent evaluation an average of 33.51 months after the procedure. The evaluation included radiographs, physical examination, patient survey, and medical record review. The average decreases in radiographic angles were as follows: Hallux abductus: 19.97 degrees, relative intermetatarsal angle: 7.49 degrees, proximal articular set angle: 13.9 degrees. Twenty-seven cases demonstrated a negative proximal articular set angle. Only five of these cases resulted in clinical hallux varus. There was an average of 4.23 mm. of first metatarsal shortening with this procedure. Average postoperative range of motion of the first metatarsophalangeal joint was 72.05 degrees. The appearance of the forefoot was judged good or excellent in 91.3% of the surgeries. Hallux position was in rectus or mild abductus in 86.9% of cases. Complication rates included hallux varus, metatarsalgia, lesion subsecond metatarsophalangeal joint, pain at the surgical site, long-term stiffness, pin tract infection, and numbness. There were no cases of osteomyelitis or avascular necrosis. Survey results revealed a high level of patient satisfaction with this procedure (94.2%). Patient satisfaction was dependent on elimination of pain and ability to wear the desired shoe gear comfortably, not on hallux position.
authors.affiliation: Department of Podiatric Surgery, Kaiser Foundation Hospital, Sacramento, California.
authors.forename: L
authors.initials: L
authors.lastname: Loretz
authors.forename: S
authors.initials: S
authors.lastname: DeValentine
authors.forename: K
authors.initials: K
authors.lastname: Yamaguchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000503:physiopathology; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D011795:Surveys and Questionnaires