title: Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up.
abstract: BACKGROUND
  Hallux valgus (HV) is a complex deformity of the forefoot altering the kinematics of walking. Many different treatment alternatives exist for the correction of hallux valgus, but to date, none has been shown to be more effective than any other. The rate of complications following hallux valgus surgery is variable and has been reported as ranging from 1 to 55 % in the scientific literature. The purpose of this preliminary prospective study was to evaluate the result of the Endolog device, an innovative titanium endomedullary nail, for the treatment of HV.
  
  
  METHODS
  Thirty patients with mild-to-severe HV were treated with the Endolog device. Clinical evaluation was assessed preoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery with a final follow-up at 4 years, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Computer-assisted measurement of weight-bearing antero-posterior radiographs was taken preoperatively and postoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery. Non-weight-bearing radiographs were taken before the patients were discharged. The radiological parameters measured included the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), and the tibial sesamoid position. Statistical analysis was carried out using the paired t test (p < 0.05).
  
  
  RESULTS
  The mean AOFAS score was 93.98 points at the 48-month follow-up. The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.
  
  
  CONCLUSIONS
  The Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.
authors.affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128, Padova, Italy. carlo.biz@unipd.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Biz
authors.affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128, Padova, Italy. marco.corradin@studenti.unipd.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Corradin
authors.affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128, Padova, Italy. ilariamd@hotmail.it.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Petretta
authors.affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128, Padova, Italy. roberto.aldegheri@libero.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Aldegheri
mesh_terms: D000328:Adult; D000368:Aged; D001858:Bone Nails / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D011446:Prospective Studies; D011859:Radiography; D013997:Time Factors; D016896:Treatment Outcome