Long term efficacy of minimal incision osteotomy for hallux abducto valgus.
OBJECTIVE
To observe and evaluate the long-term results of minimal incision osteotomy for hallux abducto valgus.


METHODS
From February 1995 to May 1999, 372 cases (705 feet) with hallux abducto valgus were treated with minimal incision osteotomy. Seventy-nine patients (150 feet) were followed up for more than five years (mean 7.5; range, 5.3-13.2 years) after surgery. The preoperative and postoperative hallux abducto valgus angles (HVA), intermetatarsal angles (IMA), tibial sesamoid position (TSP), American Orthopaedic Foot And Ankle Society (AOFAS) score, range of movement of the first metatarsophalangeal joint and lateral metatarsalgia were observed, measured and evaluated.


RESULTS
Based on clinic curative effect evaluation criterion, 56 feet (37.3%) were excellent, 88 feet (58.7%) good, 6 feet (4.0%) fair. The postoperative mean AOFAS score was 84.20 ± 4.32 points. The mean HVA decreased from 33.28° to 12.31° and the mean IMA1-2 from 11.75° to 6.80°. The TSP was corrected from an average preoperative grade of 4.29 to a grade of 3.07 by final follow-up. There was no nonunion or delayed union, no avascular necrosis, no infection, and no hallux varus. Numbness in the big toe was found in 4 feet (2.7%). The range of motion of the first metatarsophalangeal joint decreased from 70.20° to 69.53°. Of 97 feet (64.7%) with pre-operative 2-5 metatarsalgia, this had disappeared in 35 feet, improved in 54 feet and was aggravated in 8 feet postoperatively.


CONCLUSIONS
Minimal incision osteotomy is a simple and reliable technique for treating hallux abducto valgus with minimal complications.
Department of Orthopaedics, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Wei-dong
WD
Sun
Jian-min
JM
Wen
Hai-wei
HW
Hu
Yong-sheng
YS
Sun
Zhi-cheng
ZC
Sang
Ke-wei
KW
Jiang
Zhao
Z
Liang
Ting
T
Cheng
Xin-xiao
XX
Lin
Xia-bo
XB
Wu
He-ling
HL
Dai
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000502:physiology; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D055815:Young Adult