title: First metatarsal proximal opening wedge osteotomy for correction of hallux valgus deformity: comparison of straight versus oblique osteotomy.
abstract: OBJECTIVE
  The aim of this study was to compare clinical and radiographic outcomes of proximal opening wedge osteotomy using a straight versus oblique osteotomy.
  
  
  METHODS
  We retrospectively reviewed 104 consecutive first metatarsal proximal opening wedge osteotomies performed in 95 patients with hallux valgus deformity. Twenty-six feet were treated using straight metatarsal osteotomy (group A), whereas 78 feet were treated using oblique metatarsal osteotomy (group B). The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle, and distance from the first to the second metatarsal (distance) were measured for radiographic evaluation, whereas the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used for clinical evaluation.
  
  
  RESULTS
  Significant corrections in the HVA, IMA, and distance from the first to the second metatarsal were obtained in both groups at the last follow-up (p<0.001). There was no difference in the mean IMA correction between the 2 groups (6.1±2.7° in group A and 6.0±2.1° in group B). However, a greater correction in the HVA and distance from the first to the second metatarsal were found in group B (HVA, 13.2±8.2°; distance, 25.1±0.2 mm) compared to group A (HVA, 20.9±7.7°; distance, 28.1±0.3 mm; p<0.001). AOFAS scores were improved in both groups. However, group B demonstrated a greater improvement relative to group A (p=0.005).
  
  
  CONCLUSIONS
  Compared with a straight first metatarsal osteotomy, an oblique first metatarsal osteotomy yielded better clinical and radiological outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, Yonsei Altair Hospital, Seoul, Korea.
authors.forename: Eui Hyun
authors.initials: EH
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Korea.
authors.forename: Joon
authors.initials: J
authors.lastname: Jo
authors.affiliation: Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Korea.
authors.forename: Yong Gon
authors.initials: YG
authors.lastname: Koh
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Choi
authors.affiliation: Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Korea. yskimos@gmail.com.
authors.forename: Yong Sang
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D004838:Epiphyses / Q000601:surgery; D005006:Ethnicity; D005260:Female; D005528:Foot; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging* / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D034941:Upper Extremity
keywords: Hallux valgus; low-profile plate; oblique; proximal opening wedge osteotomy; straight
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