title: [Correction of high-grade sesamoid bone dislocation in hallux valgus using Austin's osteotomy with and without lateral soft tissue release].
abstract: BACKGROUND
  Aim of this study was to analyze if, using the Austin technique for correction of hallux valgus deformity, the additional soft tissue procedure is capable to achieve better correction of the sesamoid subluxation, the hallux valgus angle and the intermetatarsal angle.
  
  
  METHODS
  19 patients with 20 feet operated according to the original Austin technique and 26 patients with 28 feet operated according to a modified technique with lateral soft tissue release both with a preoperative sesamoid subluxation grade 3 were compared with the help of a standardized questionnaire in respect to clinical and radiological results.
  
  
  RESULTS
  Analyzing the clinical outcome of the two procedures, there was no statistical difference. Comparison of the radiological results revealed a significantly better correction of the sesamoid position and a better correction of hallux valgus and intermetatarsal angle by using the additional soft tissue procedure.
  
  
  CONCLUSIONS
  The lateral soft tissue procedure with release of the adductor hallucis, dissection of the deep transverse plantar ligament and mobilisation of the sesamoids is capable of a significantly better correction of the sesamoid position. Only a combination of osseus and soft tissue correction is capable to correct the pathomechanism and to guarantee long lasting results.
authors.affiliation: Orthopädisches KH Gersthof-Wien, I. Abteilung.
authors.forename: H J
authors.initials: HJ
authors.lastname: Trnka
authors.forename: A
authors.initials: A
authors.lastname: Zembsch
authors.forename: A
authors.initials: A
authors.lastname: Kaider
authors.forename: M
authors.initials: M
authors.lastname: Salzer
authors.forename: P
authors.initials: P
authors.lastname: Ritschl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006215:Hallux Valgus / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D004204:Joint Dislocations / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008683:Metatarsophalangeal Joint / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009985:Orthopedics / Q000379:methods; D017060:Patient Satisfaction; D011859:Radiography; D012716:Sesamoid Bones / Q000293:injuries / Q000601:surgery