title: Proximal Opening Wedge Osteotomy Provides Satisfactory Midterm Results With a Low Complication Rate.
abstract: Hallux valgus is one of the most common foot deformities. Proximal opening wedge osteotomy is used for the treatment of moderate and severe hallux valgus with metatarsus primus varus. However, hypermobility of the first tarsometatarsal joint can compromise the results of the operation, and a paucity of midterm results are available regarding proximal open wedge osteotomy surgery. The aim of the present study was to assess the midterm results of proximal open wedge osteotomy in a consecutive series of patients with severe hallux valgus. Thirty-one consecutive adult patients (35 feet) with severe hallux valgus underwent proximal open wedge osteotomy. Twenty patients (35.5%) and 23 feet (34.3%) were available for the final follow-up examination. The mean follow-up duration was 5.8 (range 4.6 to 7.0) years. The radiologic measurements and American Orthopaedic Foot and Ankle Society hallux-metatarsophalangeal-interphalangeal scores were recorded pre- and postoperatively, and subjective questionnaires were completed and foot scan analyses performed at the end of the follow-up period. The mean hallux valgus angle decreased from 38° to 23°, and the mean intermetatarsal angle correction decreased from 17° to 10°. The mean improvement in the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal score increased from 52 to 84. Two feet (5.7%) required repeat surgery because of recurrent hallux valgus. No nonunions were identified. Proximal open wedge osteotomy provided satisfactory midterm results in the treatment of severe hallux valgus, with a low complication rate. The potential instability of the first tarsometatarsal joint does not seem to jeopardize the midterm results of the operation.
authors.affiliation: Researcher, Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Rami
authors.initials: R
authors.lastname: Oravakangas
authors.affiliation: Professor and Head, Division of Orthopaedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Juhana
authors.initials: J
authors.lastname: Leppilahti
authors.affiliation: Physiotherapist, Department of the Physical and Rehabilitation Medicine, Oulu University Hospital, Oulu, Finland.
authors.forename: Vesa
authors.initials: V
authors.lastname: Laine
authors.affiliation: Orthopaedic Surgeon, Department of Surgery, Oulu University Hospital, Oulu, Finland. Electronic address: tuukka.niinimaki@fimnet.fi.
authors.forename: Tuukka
authors.initials: T
authors.lastname: Niinimäki
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007593:Joint Instability; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D055815:Young Adult
keywords: bunion deformity; first metatarsal; hallux valgus; metatarsus primus varus; tarsometatarsal joint