Closed wedge osteotomy in 66 patients for the treatment of moderate to severe hallux valgus.
BACKGROUND
The intention of this study was to analyze the long-term results of the proximal closing wedge osteotomy for the correction of hallux valgus deformity, modified by adding a mini L-plate for osteosynthesis.


METHODS
The outcome of a proximal first metatarsal closing wedge osteotomy was retrospectively evaluated after a mean follow-up of 52 months. A total of 66 female patients (86 feet) participated in this study. The AOFAS-score was used to evaluate the postoperative results. Pre- and postoperative weight-bearing radiographs were used to evaluate the osseous development.


RESULTS
95.5% of the patients were satisfied, 3 patients (4.5%) were not satisfied with the overall result of the operation. Transfer metatarsalgia was registered in 7 of 50 cases. The mean improvement of the HV-angle was 22.1 degrees (36.4 degrees to 14.3 degrees ) and the intermetatarsal angle was reduced from a mean of 17.6 degrees to a mean of 6.5 degrees . The mean first metatarsal shortening was 3.2mm. The mean AOFAS-score was 78 points.


CONCLUSIONS
The results confirm, that the closing wedge osteotomy is indicated for moderate to severe hallux valgus. The shortening of the first ray is comparable with other well-established operative procedures. The risk of transfer metatarsalgia can only be lightly reduced by this procedure.
Department of Orthopaedics and Traumatology, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 München, Germany.
Alexander
A
Nedopil
Maximilian
M
Rudert
Reiner
R
Gradinger
Tibor
T
Schuster
Wolfgang
W
Bracker
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D016474:Weight-Bearing