Comparison of Radiographic Measurements Before and After Triplane Tarsometatarsal Arthrodesis for Hallux Valgus

摘要

We present a comparison of preoperative and final postoperative first ray measurements in 109 feet after triplane tarsometatarsal arthrodesis at a mean follow-up time of 17.4 months. Preoperative and final postoperative first ray variables including intermetatarsal angle (IMA), hallux valgus angle (HVA), tibial sesamoid position (TSP), distal metatarsal articular angle (DMAA), Seiberg index, metatarsal rotation angle (MRA), sesamoid subluxation, osseous union, and hardware failure were evaluated. Measurements were made by consistently using the middiaphyseal line of the bone segments for both preoperative and postoperative assessments. The mean preoperative HVA, IMA, and TSP were 22.9 degrees, 13.3 degrees, and 4.6. The mean differences (95% confidence interval) in preoperative and postoperative values were -14.9 degrees (-16.3 degrees to -13.4 degrees) for HVA, -7.7 degrees (-8.2 degrees to -7.2 degrees) for IMA, and -2.6 (-2.8 to -2.3) for TSP. Among bunions with MRA measurements, the mean difference was -12.3 degrees (-14.5 degrees to -10.0 degrees). The preoperative to postoperative DMAA decreased by a mean of -14.2 degrees (-15.9 degrees to -12.6 degrees). The results of this study suggest that triplane tarsometatarsal arthrodesis produces appropriate correction of hallux valgus radiographic parameters. (C) 2019 by the American College of Foot and Ankle Surgeons. All rights reserved.