title: Percutaneous distal metatarsal osteotomy for correction of hallux valgus. Surgical technique.
abstract: BACKGROUND
  Distal osteotomy of the first metatarsal is indicated for the surgical treatment of mild-to-moderate hallux valgus deformity. The aim of this study was to evaluate the results of a subcapital distal osteotomy of the first metatarsal with use of a percutaneous technique.
  
  
  METHODS
  From 1996 to 2001, 118 consecutive percutaneous distal osteotomies of the first metatarsal were performed for the treatment of painful mild-to-moderate hallux valgus in eighty-two patients. The patients were assessed with a clinical and radiographic protocol at a mean of 35.9 months postoperatively. The American Orthopaedic Foot and Ankle Society (AOFAS) hallux-metatarsophalangeal-interphalangeal scale was used for the clinical assessment.
  
  
  RESULTS
  The patients were satisfied following 107 (91%) of the 118 procedures. The mean score on the AOFAS scale was 88.2 +/- 12.9 points. The postoperative radiographic assessments showed a significant change (p < 0.05), compared with the preoperative values, in the mean hallux valgus angle, first intermetatarsal angle, distal metatarsal articular angle, and sesamoid position. The valgus deformity recurred after three procedures (2.5%), the first metatarsophalangeal joint was stiff but not painful after eight (6.8%), and a deep infection developed after one (0.8%). The infection resolved with antibiotic therapy.
  
  
  CONCLUSIONS
  The percutaneous technique proved to be reliable for the correct execution of a distal linear osteotomy of the first metatarsal for the correction of a painful mild-to-moderate hallux valgus deformity. The clinical results appear to be comparable with those obtainable with traditional open techniques, with the additional advantages of a minimally invasive procedure, a substantially shorter operating time, and a reduced risk of complications related to surgical exposure.
authors.affiliation: Department of Orthopaedics, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Magnan
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bortolazzi
authors.forename: Elena
authors.initials: E
authors.lastname: Samaila
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pezzè
authors.forename: Nicola
authors.initials: N
authors.lastname: Rossi
authors.forename: Pietro
authors.initials: P
authors.lastname: Bartolozzi
mesh_terms: D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008682:Metatarsal Bones / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*