Use of Minimally Invasive Distal Metatarsal Osteotomy for Correction of Hallux Valgus

摘要

Purpose Minimally invasive surgeries have become increasing popular in Orthopaedics. This study evaluated the clinical and radiographic outcomes of application of the concept for correction of mild-to-moderate hallux valgus deformity. Methods From November 2005 to Feb 2010, 20 patients with hallux valgus deformity had distal metatarsal osteotomy performed using the minimally invasive surgical techniques described by P. Bosch. Three patients had bilateral operation done at the same setting. The patient age ranged from 29 years to 75 years (mean 55.1 years) with 2 men and 18 women. One 2?mm Kirschner wire was used to splint the osteotomy site, which was removed after 4 weeks to 5 weeks. The mean follow-up time was 22 months. Results All except one foot showed excellent to good grading using the American Orthopaedic Foot and Ankle Society Hallux Scale (total 100 points). The mean score improved from preoperative 53.0 points to postoperative 91.8 points. The hallux valgus angle improved from a preoperative mean of 31.3° to 15.7°, and the first intermetatarsal angle improved from 16.7° to 7.7°. There was no major complication encountered. All patients showed bony union with no avascular necrosis. Three patients had mild pin tract infection. Two patients had backing out of the K-wire and one of them required re-insertion. So far, no patients required reoperation due to recurrence. Conclusion Good clinical and radiographic results have been achieved with minimally invasive techniques for treatment of hallux valgus. This is an acceptable alternative operation for mild-to-moderate hallux valgus.