[Treatment of hallux valgus by remodeling the bone and articular morhpology of the first metatarsophalangeal joint].
OBJECTIVE
To evaluate the physiological function and the anatomic structure of the first metatarsophalangeal joint for the patient with hallux valgus after a remodeling operation with the Keller's method.


METHODS
From April 2004 to November 2006, the first metatarsophalangeal joints in 11 patients (22 feet) with hallux valgus were remodeled with the Keller's operation. There were 3 males and 8 females, aged 51-73 years. According to the Piggot typing standard, there were 17 feet of type I (deflexion) and 5 feet of type II (semiluxation). The hallux valgus angles (HVAs) were 24-49 degrees (average, 37 degrees). The intermetatarsal angles (IMAs) were 9.0-13.5 degrees (average, 11.5 degrees). The curative effect and the anatomic structure were evaluated by the follow-up and the X-ray examination.


RESULTS
All the cases were followed up for 6 to 30 months after operation (average, 14 months). According to the standard of ZHU Li Hua, et al, the results were excellent in 18 feet, good in 3 feet, and poor in 1 foot. The X-ray films showed that the first metatarsophalangeal joint of 14 feet developed mortar-like false articulation, and 8 feet developed partial false articulation. HVAs were 7-16 degrees (average, 11 degrees). IMAs were 9.0-13.5 degrees (average, 11.5 degrees). According to the Piggot typing standard, there were 12 feet of type I (fitter) and 10 feet of type II (deflexion).


CONCLUSIONS
For the patients with hallux valgus, the remodeling of the first metatarsophalangeal joint by the Keller's operation can rectify HVA, improve the stability of the joints, and prevent occurrence of the insufficient muscle strength after operation.
Shao
Yong
Y
Department of Orthopedics, Third People's Hospital of Chengdu, Chengdu Sichuan, 610031, PR China. shaoyong180@126.com
Chen
Qin
Q
Zhou
Zheng
Z
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery; D008683:Metatarsophalangeal Joint / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D014033:Toe Joint / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome