[Austin's Operation at the First Orthopaedic Clinic in Bratislava.].
There are more than 200 types of surgical treatment of hallux valgus, but new modifications still appear. At the authors' Clinic during the last four years some of the patients are operated by Austin's operation. The operation is made under anaesthesia type "foot block". The operation is performed in a bloodless field, achieved by an Esmarch bandage. The incision is dorsomedial above the 1st MTP joint and is about 5 cm long. The incision of the bursa is Y shaped, with the base on the proximal phalanx of the hallux. We ablate the exostosis, deliberate the fibular portion of the articular capsule of MT and in case of more difficult redressibility of the hallux tenotomy of the m. adductor hallucis is performed. Osteotomy of the distal metatarsus is made transversally in a V--shaped manner at an agle of 60 degrees . The distal osteo-tomized fragment is lateralized by one to two thirds of the metatarsal width. This position is fixed by a Kirschner wire inserted by the percutaneous paraosseous route through the hallux, the space between the first and second MT and fixed in the tarsus. Y-shaped bursotomy and artrotomy is sutured in such as way to achieve stability of the osteotomy and redressing of the hallux. The stitches are removed 14 days after operation. The Kirschner wires are left for four weeks. Postoperation treatment proceeds in a specially shaped postooperation sandal. By this method since the beginning of 1992 till the end of 1995 at the authors' Clinic 48 feet of 36 patients were operated (42 women, 6 men). The mean age at the time of surgery was 44.5 years (22 to 58 years). The mean period of work inability was 9.7 weeks. The patients were examined at least 6 months after surgery and 40 excellent results were recorded (83%), 7 (15%) good results and 1 (2%) poor result. Complications were rare. In two patients there was secondary healing of the surgical wound, in two instances infection of the wound occurred. Key words: hallux valgus, Austin's operation, chevron osteotomy.
Vojtassák
J
J
I. ortopedická klinika LF UK a FN, Bratislava.
Svec
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