Reconstruction of hallux limitus deformity using a first metatarsal sagittal-Z osteotomy.
A sagittal-Z osteotomy was used for reconstruction of symptomatic grade I and grade II hallux limitus deformity in 10 patients using the Regnauld classification system. This surgical method was also used in a patient to reconstruct a structurally elevated first metatarsal as an adverse sequela of previous hallux valgus surgery. All patients exhibited evidence of radiographic metatarsus primus elevatus (MPE) and/or an anatomically elongated first metatarsal (EM). Linear comparison of first and second metatarsal length was performed in the transverse plane on dorsoplantar weightbearing radiographs. A long first metatarsal (positive metatarsal protrusion distance) was considered an anatomically elongated metatarsal. Metatarsus primus elevatus was evaluated by comparing the dorsal cortical margin of the first and second metatarsals and/or comparing the first metatarsal-cuneiform joint axis with the talonavicular joint axis. Metatarsus primus elevatus was therefore defined as a position of the dorsal cortical margin of the first metatarsal 5 mm superior to that of the second. A dorsal position of the first metatarsal-cuneiform joint axis in relation to the talonavicular joint axis also established MPE. A total of 11 patients underwent a total of 13 procedures. There were eight excellent results (73%) and three good results (27%). There were no fair or poor results.
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D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005530:Foot Deformities / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D006214:Hallux / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*