[Austin procedure for the treatment of hallux valgus part I: surgical technique.].
Detailed description of the surgical technique of Austin procedure for hallux valgus is given in this study. The operation is suitable for patients without osteoarthritic changes of I. metatarsophalangeal joint. The operation is mostly performed under local anaesthesia and without turniquet. A medial longitudinal approach is used. It is possible to divide the procedure into five basic stages: Y-shaped incision of medial capsule, so-called champagne-glass approach; lateral release of capsule (conjoined tendon); buniectomy of head of the I. metatarsal; horizontal V-shaped osteotomy and lateral dis placement of metatarsal head with subsequent exci sion of the bone projection along the medial meta tarsal shaft; closure of medial capsule with reconstruction of medial collateral ligament. A short hallux spica cast is applied for two weeks. All the stages of the procedure should be performed correctly, otherwise significant complications may occur. The most frequent technical errors are: improper angle of osteotomy, an excessive angle (90 dg.) results in the instability of fragments, too small an angle (40 dg.) in the necrosis of the wed ge of diaphyseal fragment and in excessive shorte ning of I. metatarsal; overcorrection of the metatarsal head laterally, approximately more than 4 mm, results in the insta bility and the subsequent lateral displacement of the capital fragment. For these reasons the operation should be performed by an experienced surgeon, who is familiar with this technique. Key words: hallux valgus, Austin procedure, osteotomy of metatarsal head, surgical technique.
Bartonícek
J
J
Ortopedická klinika 3. lékarské fakulty KU, Praha.
Stehlík
J
J
Dlouhý
M
M