First Metatarsal Proximal Opening Wedge Osteotomy for Correction of Hallux Valgus Deformity: Comparison of Straight versus Oblique Osteotomy |
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Authors: | Seung Hwan Han Eui Hyun Park Joon Jo Yong Gon Koh Jin Woo Lee Woo Jin Choi Yong Sang Kim |
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Institution: | 1.Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.;2.Department of Orthopaedic Surgery, Yonsei Altair Hospital, Seoul, Korea.;3.Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Korea. |
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Abstract: | PurposeThe aim of this study was to compare clinical and radiographic outcomes of proximal opening wedge osteotomy using a straight versus oblique osteotomy.Materials and MethodsWe retrospectively reviewed 104 consecutive first metatarsal proximal opening wedge osteotomies performed in 95 patients with hallux valgus deformity. Twenty-six feet were treated using straight metatarsal osteotomy (group A), whereas 78 feet were treated using oblique metatarsal osteotomy (group B). The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle, and distance from the first to the second metatarsal (distance) were measured for radiographic evaluation, whereas the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used for clinical evaluation.ResultsSignificant corrections in the HVA, IMA, and distance from the first to the second metatarsal were obtained in both groups at the last follow-up (p<0.001). There was no difference in the mean IMA correction between the 2 groups (6.1±2.7° in group A and 6.0±2.1° in group B). However, a greater correction in the HVA and distance from the first to the second metatarsal were found in group B (HVA, 13.2±8.2°; distance, 25.1±0.2 mm) compared to group A (HVA, 20.9±7.7°; distance, 28.1±0.3 mm; p<0.001). AOFAS scores were improved in both groups. However, group B demonstrated a greater improvement relative to group A (p=0.005).ConclusionCompared with a straight first metatarsal osteotomy, an oblique first metatarsal osteotomy yielded better clinical and radiological outcomes. |
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Keywords: | Hallux valgus proximal opening wedge osteotomy straight oblique low-profile plate |
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