Surgical treatment of moderate to severe Hallux Valgus: proximal metatarsal osteotomy and distal soft tissue release

摘要

> face="Verdana" size="2">Objective: Evaluate clinical and radiological results obtained with the combination of the first metatarsal osteotomy proximal and distal soft release according Mann-Coughlin technique in the treatment of moderate to severe hallux valgus parts. Methods: A retrospective study was conducted on 16 patients (30 feet) with hallux moderate and severe valgus. They underwent surgery at two Comprehensive Diagnostic Centers in Apure State, in the Bolivarian Republic of Venezuela, by the same surgeon from March 2009 to December 2012. Only four patients did not continue to follow up. Clinical and radiographic results were evaluated. Results: an average of 87.5 points improvement was found according to the scale of the American Society of Orthopaedic Foot and Ankle (AOFAS for its acronym in English). The hallux valgus angle improved from 34.8° to 16.6° and average intermetatarsal angle improved from 16.2° to 8.8° after surgery. There were no hallux varus. Only two patients had dehiscence of the surgical wound, and a patient had loosening of the Kirschner needle. Conclusions: the proximal osteotomy of the first metatarsal combined with distal soft tissue release is a good choice for surgical correction in the treatment of moderate to severe hallux valgus, it is easy to reproduce and it has similar complications than other techniques.