title: Distal soft tissue realignment and proximal metatarsal countersinking osteotomy for moderate to severe hallux valgus.
abstract: BACKGROUND
  Hallux valgus is a common condition and surgical correction has remained a challenge.
  
  
  OBJECTIVE
  To evaluate the results of distal soft tissue realignment and proximal 1st metatarsal countersinking osteotomy for the treatment of moderate to severe hallux valgus deformity.
  
  
  METHODS
  This prospective study included 33 ft in 28 patients. The deformity was moderate in 27 ft (23 patients), severe in six ft (five patients) and bilateral in five patients. All operations were performed as a primary procedure with an average duration of follow-up of 28.2 months (range 10-45 months).
  
  
  RESULTS
  The average hallux valgus angle was improved from 32.5° to 8° and the first intermetatarsal angle from 16.5° to 7.7°. According to the symptomatic score of Broughton and Winson, 22 ft (18 patients) were rated excellent, nine good and two poor. The average American Orthopedic Foot Ankle Society score at the final follow-up was 89.3 (range 65-100). Recurrence of the valgus deformity was seen in three patients and hallux varus in two patients.
  
  
  CONCLUSIONS
  The current procedure proved to be effective to correct all components of hallux valgus deformity regardless of its severity.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Mansoura University Hospital, Mansoura, Egypt. thabetortho20032003@yahoo.com
authors.forename: Mohamed F
authors.initials: MF
authors.lastname: Mostafa
authors.forename: Gamal
authors.initials: G
authors.lastname: El-Adl
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012019:Reflex Sympathetic Dystrophy / Q000209:etiology; D012720:Severity of Illness Index; D055815:Young Adult