title: Proximal metatarsal osteotomy for hallux valgus: comparison of outcome for moderate and severe deformities.
abstract: BACKGROUND
  We compared the results of a distal soft-tissue procedure with a proximal crescentic osteotomy of the first metatarsal for moderate and severe hallux valgus.
  
  
  METHODS
  The series consisted of 54 feet treated with this procedure. The average followup was 30 months. Fifty-four feet were divided into two groups including Group M (moderate) (24 feet, preoperative hallux valgus angle of 40 degrees or less and preoperative intermetatarsal angle of less than 18 degrees) and Group S (severe) (30 feet, preoperative hallux valgus angle of greater than 40 degrees or preoperative intermetatarsal angle of 18 degrees or greater).
  
  
  RESULTS
  The difference between Group M and S was not significant with regard to the age of patients, duration of followup, or postoperative pain and function scores on the American Orthopaedic Foot and Ankle Society scale. However, postoperative alignment score in Group M was significantly greater than that in Group S (p = 0.038). Postoperative hallux valgus and intermetatarsal angles in Group S were significantly greater than those in Group M, respectively (p = 0.025, p = 0.001). The prevalence of recurrent hallux valgus (hallux valgus angle of 20 degrees or greater) in Group S was significantly higher than that in Group M (p = 0.013).
  
  
  CONCLUSIONS
  This procedure is an effective method for relieving pain and improving function regardless of the severity of hallux valgus. However, the correction of moderate hallux valgus is likely to be better than that of severe hallux valgus.
authors.affiliation: Department of Orthopedic Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki 569-8686, Osaka, Japan. ort071@poh.osaka-med.ac.jp
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Okuda
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Toshito
authors.initials: T
authors.lastname: Yasuda
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Jotoku
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shima
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D016896:Treatment Outcome