title: Plate fixation for crescentic metatarsal osteotomy in the treatment of hallux valgus: an eight-year followup study.
abstract: BACKGROUND
  Distal soft tissue realignment and crescentic metatarsal osteotomy is a popular procedure in the treatment of hallux valgus. The traditional technique of screw fixation for crescentic osteotomy is technically demanding, and the inferior stability of this construct has been described. We evaluated the long-term results of a modified fixation method.
  
  
  METHODS
  Twenty-six patients (32 feet) undergoing this procedure were retrospectively reviewed. Five patients (six feet) were lost to followup. Mean age of the patients was 47 (14 to 74) years. The osteotomy was fixed with a 2.7 mm AO plate. Assessment of clinical and radiographic results was performed at a mean followup of 2.7 (1.3 to 7.2) years and 8.0 (6.1 to 12.0) years, respectively.
  
  
  RESULTS
  The mean American Orthopaedic Foot and Ankle Society (AOFAS) score improved from 57.9 to 90.5 at 2.7 years of mean followup, whereas the patient satisfaction rate was 96%. The intermetatarsal angle (IMA) and hallux valgus angle (HVA) improved from the mean preoperative values of 16.1 degrees and 34.2 degrees to 9.5 degrees and 16.3 degrees. At eight years of mean followup, the mean AOFAS score and patient satisfaction rate remained at 88.5% and 92%. The mean IMA and mean HVA were 9.7 degrees and 17.0 degrees. Complications included one case of hallux varus (4%) and two cases of recurrence (8%). The osteotomy achieved union in all cases.
  
  
  CONCLUSIONS
  Dorsal plate fixation of crescentic metatarsal osteotomy is a technically easier procedure. Equally good results can be achieved when compared with screw fixation methods, and the results can be maintained long-term.
authors.affiliation: Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Tsing Chung Koon Road, Hong Kong, China. chow_fyh@yahoo.com
authors.forename: Francis Yuen-hon
authors.initials: FY
authors.lastname: Chow
authors.forename: Tun Hing
authors.initials: TH
authors.lastname: Lui
authors.forename: Kin Wa
authors.initials: KW
authors.lastname: Kwok
authors.forename: Yuk Yin
authors.initials: YY
authors.lastname: Chow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy; D017060:Patient Satisfaction; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome