First tarsometatarsal joint derotational arthrodesis--a new operative technique for flexible hallux valgus without touching the first metatarsophalangeal joint.
No operative technique for hallux valgus has been introduced in which the first metatarsophalangeal joint is not touched. We report the first tarsometatarsal joint derotational arthrodesis in which we mimic the function of the peroneus longus tendon without involving the first metatarsophalangeal joint, allowing function of the windlass mechanism without interference. We treated 66 patients (62 women and 4 men) with 84 flexible hallux valgus feet using our new operative technique. Preoperative and postoperative follow-up weightbearing radiographs were evaluated. Most patients had a pronation type foot (78%) preoperatively, and mean correction in hallux valgus and intermetatarsal angle was 20° and 9°, respectively (p < .001). The LaPorta classification showed a median change of 2.5 U (p < .001). We have described a new operative technique for flexible hallux valgus. The first tarsometatarsal joint derotational arthrodesis showed notable correction angles in hallux valgus, although the first metatarsophalangeal joint was left intact.
Division of Orthopaedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland. Electronic address: tero.klemola@ppshp.fi.
Tero
T
Klemola
Professor, Division of Orthopaedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland.
Juhana
J
Leppilahti
Division of Orthopaedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland.
Salla
S
Kalinainen
Department of Surgery and Anesthesiology, Oulu University Hospital, Oulu, Finland.
Pasi
P
Ohtonen
Department of Radiology, Oulu University Hospital, Oulu, Finland.
Risto
R
Ojala
Division of Orthopaedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland.
Olli
O
Savola
D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones; D008683:Metatarsophalangeal Joint / Q000601:surgery; D008875:Middle Aged
4; closed first metatarsophalangeal joint; hallux valgus; operative technique; peroneus longus; rotational correction