title: OSTEOTOMY OF THE FIRST METATARSAL BASE ON THE TREATMENT OF MODERATE TO SEVERE HALLUX VALGUS RESULTS AFTER MEAN FOLLOW-UP TIME OF EIGHT YEARS.
abstract: OBJECTIVE
  To assess the result of the treatment of moderate to severe hallux valgus with osteotomy of the first metatarsal base associated to distal release of soft parts and medial capsuloplasty.
  
  
  METHODS
  13 patients were assessed (15 feet) submitted to surgical treatment of hallux valgus moderate to severe. The mean follow-up time was 102 months; there were 12 female and 1 male patients, with mean age at the time of surgery of 49 years. The patients enrolled were interviewed according to the questionnaire developed by our service, clinically examined according to the AOFAS scale and submitted to X-ray tests for comparing the results with baseline images.
  
  
  RESULTS
  The mean score of the AOFAS scale obtained at the final assessment was 82 points. Nine of the 15 feet (60%) showed some late complications, with four (27%) varus deformities, three (20%) recurrences; two patients (13%) presenting with pain complaints with no associated deformity. In the hallux metatarsophalangeal joint, movement loss was 41° (57%); dorsiflexion movement was mostly affected, with a mean loss of 37° (60%). The range of motion on the contralateral intact side served as control group. Arthrosis progression was seen on the final X-ray evaluation. In all cases, shortening and lifting of the first metatarsal were noticed; however, we couldn't correlate the shortening and lifting with metatarsalgia, plant callosity or lower scoring on the AOFAS scale at the final evaluation.
  
  
  CONCLUSIONS
  The osteotomy technique by the basis and with distal realignment of soft parts employed in the treatment of moderate to severe hallux valgus showed a high rate of late complications. Due to the high number of complications, we believe that adopting this technique for correcting hallux valgus deformities should be carefully considered.
authors.affiliation: Assistant Physician, Foot and Ankle Group, Santa Casa de Misericórdia de Sao Paulo, Brazil.
authors.forename: Marco Túlio
authors.initials: MT
authors.lastname: Costa
authors.affiliation: Physician, Former Intern of the Foot and Ankle Group, Santa Casa de Misericòrdia de Sao Paulo, Brazil.
authors.forename: Roberto Zambelli
authors.initials: RZ
authors.lastname: de Almeida Pinto
authors.affiliation: Assistant Physician, Foot and Ankle Group, Santa Casa de Misericórdia de Sao Paulo, Brazil.
authors.forename: Ricardo Cardenuto
authors.initials: RC
authors.lastname: Ferreira
authors.affiliation: Assistant Physician, Foot and Ankle Group, Santa Casa de Misericórdia de Sao Paulo, Brazil.
authors.forename: Minoru Alessandro
authors.initials: MA
authors.lastname: Sakata
authors.affiliation: Assistant Physician, Foot and Ankle Group, Santa Casa de Misericórdia de Sao Paulo, Brazil.
authors.forename: Gastāo Guilherme
authors.initials: GG
authors.lastname: Frizzo
authors.affiliation: Physician, Head, Foot and Ankle Group, Santa Casa de Misericòrdia de Sao Paulo, Brazil.
authors.forename: Roberto Attílio Lima
authors.initials: RA
authors.lastname: Santin
keywords: Follow-up studies; Hallux valgus; Metatarsal bones; Metatarsophalangeal joint; Osteotomy; Surgery