Modified Simmonds-Menelaus procedure for moderate or severe adult hallux valgus.
OBJECTIVE
The purpose of this study was to present the clinical and radiological results of modified Simmonds-Menelaus technique, performed as a proximal, medially-based, open-wedge osteotomy of the first metatarsal, in cases of moderate or severe adult hallux valgus deformity.


METHODS
Fifty-one feet of 47 patients underwent surgery due to hallux valgus. Mean age was 41.2±14.0 years, and mean follow-up period was 99.5±36.0 months. Patients were evaluated with standing anteroposterior (AP) and lateral radiographies obtained in the preoperative and early postoperative periods, and during final follow-up. The parameters of hallux valgus angle (HVA), intermetatarsal angle (IA), metatarsal distal phalangeal angle (MDPA), and first metatarsal length (ML) were measured. For clinical evaluation, American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal (MTP-IP) scale was used.


RESULTS
Mean preoperative HVA was 36.9°±7.3°, mean early postoperative HVA was 16.6°±6.2°, and mean final postoperative HVA was 28.9°±11.5°. Mean preoperative IA was 17.3°±4.5°, mean early postoperative IA was 8.8°±3.6°, and mean final postoperative IA was 14.3°±4.9°. Mean AOFAS hallux MTP-IP score was 71.9±20.1 at final follow-up.


CONCLUSIONS
From studies in the available literature, it is not clear whether the proximal open-wedge osteotomy technique itself is unsuccessful in adults or the lack of internal fixation led to failure. Application of an adequate fixation material should be used in order to avoid the collapse of the graft and to maintain the correction of the radiological parameters.
Metin Sabancı Baltalimanı Bone Diseases Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey. yemreakman@gmail.com.
Yunus Emre
YE
Akman
Metin Sabancı Baltalimanı Bone Diseases Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Merter
M
Yalçınkaya
İstanbul Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Esra
E
Çirçi
Metin Sabancı Baltalimanı Bone Diseases Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Yunus
Y
Atıcı
İstanbul Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Yusuf
Y
Öztürkmen
Medical Park Bahcelievler Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Ahmet
A
Doğan
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000000981:diagnostic imaging*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011184:Postoperative Period; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D055815:Young Adult