title: Hallux valgus in males--part 2: radiographic assessment of surgical treatment.
abstract: BACKGROUND
  In an early report on this patient cohort, we concluded that a hallux valgus deformity in males is frequently hereditary in nature. An increase in the distal metatarsal articular angle (DMAA) was observed to be the major defining characteristic of hallux valgus in males. In this follow-up study, our goal was to evaluate the effectiveness of surgical treatment for this cohort of male patients.
  
  
  METHODS
  Data from 50 feet of male patients with hallux valgus who were surgically treated by the same surgeon between 1985 and 2005 were retrospectively analyzed. The technique was algorithmically chosen according to the severity and complexity of the deformity. Thus, 10 chevron osteotomies, 9 biplanar chevron osteotomies, 12 Mitchell osteotomies, 9 scarf osteotomies, and 10 basilar first metatarsal osteotomies were performed. The average follow-up was 10 years (range, 2-20).
  
  
  RESULTS
  After analyzing the angular radiological parameters, sesamoid subluxation, and the articular congruency, most procedures proved to have achieved adequate correction of the angular deformities. When examining each of the procedures separately, 4 of the 5 procedures had similar corrective capacities; the scarf osteotomy however had decidedly inferior results. The improvement in the postoperative American Orthopaedic Foot and Ankle Society (AOFAS) score demonstrated the clinical and functional improvement.
  
  
  CONCLUSIONS
  The algorithm was based mainly upon the presence of increased DMAA and increased severity of angular deformities. We conclude that hallux valgus deformities in males were adequately corrected with the selected techniques. Greater difficulty or resistance to surgical treatment could not be detected when we contrasted our results to females. The scarf osteotomy proved to have an inferior corrective capacity compared to the other techniques used in this series.
  
  
  METHODS
  Level III, retrospective comparative series.
authors: UNIFESP-Escola Paulista de Medicina, São Paulo, SP, Brazil. caionerymd@gmail.com
authors: Caio
authors: C
authors: Nery
authors: Michael J
authors: MJ
authors: Coughlin
authors: Daniel
authors: D
authors: Baumfeld
authors: Flávio José
authors: FJ
authors: Ballerini
authors: Silvia
authors: S
authors: Kobata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: hallux valgus; hallux valgus in males; surgical treatment