title: Prognosis of painful plantar callosity after hallux valgus correction without lesser metatarsal osteotomy.
abstract: BACKGROUND
  Painful plantar callosities under lesser metatarsal heads are commonly associated with hallux valgus. The purpose of the present study was to evaluate the prognosis of painful plantar callosities after hallux valgus correction without lesser metatarsal osteotomy in hallux valgus deformity.
  
  
  METHODS
  Between September 2004 and June 2007, 31 patients (40 feet) underwent proximal chevron first metatarsal osteotomy with a distal soft tissue procedure, with preoperatively painful plantar callosities under lesser metatarsal heads. Clinical results were evaluated using a visual analogue scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) hallux-metatarsophalangeal interphalangeal scales, and a modified 70-point clinical scale. Radiographic evaluations included hallux valgus angle and intermetatarsal angle.
  
  
  RESULTS
  Thirty-two (80%) of the 40 feet had no pain and callosity and 5 (12.5%) had no pain but residual plantar callosities, and 3 (7.5%) were not improved at final evaluation. The mean VAS and AOFAS scores were improved from 7.8 +/- 1.6 to 1.9 +/- 1.5 points and from 53.8 +/- 14.2 to 92.6 +/- 15.3 points, respectively. In terms of the 70-point clinical scale, overall clinical results were good in 34 feet and fair in 6. The mean hallux valgus and intermetatarsal angles were improved from 36.6 +/- 6.2 to 12.5 +/- 5.9 degrees and from 17.5 +/- 3.9 to 8.6 +/- 3.5 degrees, respectively.
  
  
  CONCLUSIONS
  Painful plantar callosities under the lesser metatarsals in patients with hallux valgus deformity can be improved by hallux valgus correction alone without lesser metatarsal osteotomy.
authors.affiliation: Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Korea. kbleeos@chonnam.ac.kr
authors.forename: Keun-Bae
authors.initials: KB
authors.lastname: Lee
authors.forename: Ju-Kwon
authors.initials: JK
authors.lastname: Park
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Park
authors.forename: Hyung-Yeon
authors.initials: HY
authors.lastname: Seo
authors.forename: Myung-Sun
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000328:Adult; D002145:Callosities / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D011379:Prognosis; D011859:Radiography