title: Can Double Osteotomy Be a Solution for Adult Hallux Valgus Deformity With an Increased Distal Metatarsal Articular Angle?
abstract: No previous study has reported the results of double metatarsal osteotomy for adult hallux valgus deformity with an increased distal metatarsal articular angle (DMAA). The purpose of the present study was to evaluate the results after double metatarsal osteotomy in adult patients with incongruent hallux valgus deformity. We retrospectively reviewed 16 cases of consecutive first metatarsal double metatarsal osteotomy without lateral soft tissue release in 14 patients with symptomatic hallux valgus associated with an increased DMAA (≥15° after proximal chevron osteotomy on intraoperative radiographs). Clinical results were assessed using the American Orthopaedic Foot and Ankle Society scale and the visual analog scale. The radiographic results were assessed over time, and changes in the DMAA and the relative length of the first metatarsal were assessed by measuring each value preoperatively and at the last follow-up visit. The American Orthopaedic Foot and Ankle Society and visual analog scale scores were significantly improved after surgery. The hallux valgus angle and intermetatarsal angle were stabilized >3 months after surgery. The sesamoid position did not increase significantly beyond the immediate postoperative period. The mean DMAA was corrected from 21.6° (range 15° to 29°) preoperatively to 11.1° (range -2° to 17°) at the last follow-up visit. The mean amount of shortening of the first metatarsal after surgery was 5.5 (range 4 to 7) mm. In conclusion, double metatarsal osteotomy without lateral soft tissue release in adult hallux valgus deformity results in high postoperative recurrence and complication rates.
authors.affiliation: Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, Korea.
authors.forename: Chul Hyun
authors.initials: CH
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Seoul Paik Hospital, Institute for Research of Foot and Ankle Diseases, Inje University, Seoul, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, Korea.
authors.forename: Jeong Jae
authors.initials: JJ
authors.lastname: Moon
authors.affiliation: Department of Orthopaedic Surgery, Seoul Paik Hospital, Institute for Research of Foot and Ankle Diseases, Inje University, Seoul, Korea. Electronic address: leewoochun@gmail.com.
authors.forename: Woo Chun
authors.initials: WC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: distal metatarsal articular angle; double metatarsal osteotomy; great toe; hallux valgus