title: Additional surgical factors affecting the recurrence of hallux valgus after Ludloff osteotomy.
abstract: We reviewed 91 patients (103 feet) who underwent a Ludloff osteotomy combined with additional procedures. According to the combined procedures performed, patients were divided into Group I (31 feet; first web space release), Group II (35 feet; Akin osteotomy and trans-articular release), or Group III (37 feet; Akin osteotomy, supplementary axial Kirschner (K-) wire fixation, and trans-articular release). Each group was then further subdivided into severe and moderate deformities. The mean hallux valgus angle correction of Group II was significantly greater than that of Group I (p = 0.001). The mean intermetatarsal angle correction of Group III was significantly greater than that of Group II (p < 0.001). In severe deformities, post-operative incongruity of the first metatarsophalangeal joint was least common in Group I (p = 0.026). Akin osteotomy significantly increased correction of the hallux valgus angle, while a supplementary K-wire significantly reduced the later loss of intermetatarsal angle correction. First web space release can be recommended for severe deformity. Additionally, K-wire fixation (odds ratio (OR) 5.05 (95% confidence interval (CI) 1.21 to 24.39); p = 0.032) and the pre-operative hallux valgus angle (OR 2.20 (95% CI 1.11 to 4.73); p = 0.001) were shown to be factors affecting recurrence of hallux valgus after Ludloff osteotomy.
authors.affiliation: Veterans Health Service Medical Center, Department of Orthopaedic Surgery, 6-2 Dunchon-dong, Kangdong-gu, Seoul 134-060, Korea.
authors.forename: G W
authors.initials: GW
authors.lastname: Choi
authors.forename: W J
authors.initials: WJ
authors.lastname: Choi
authors.forename: H S
authors.initials: HS
authors.lastname: Yoon
authors.forename: J W
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006215:Hallux Valgus / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology*; D012008:Recurrence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Akin osteotomy; Combined procedure; Distal soft-tissue procedure; Hallux valgus; Ludloff osteotomy; Recurrence