Short-term effectiveness of the first ray tri-plane osteotomy and other metatarsal basal osteotomy for hallux valgus with moderate and severe metatarsus adductus_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHANG Xin ¹ , ZHANG Yunlong ¹ , YANG Jie ² , LI Yi ² , ZHANG Yan ² , WEN Xiaodong ² ,  LIANG Xiaojun ²

1. Xi’an Medical University, Xi’an Shaanxi, 710068, P.R.China;
2. Department of Foot and Ankle Surgery, Honghui Hospital Affiliated to Medical School of Xi’an Jiaotong University, Xi’an Shaanxi, 710054, P.R.China;

Corresponding author：

LIANG Xiaojun, Email: liangxj33369@163.com

Keywords：

Metatarsus adductus; hallux valgus; tri-plane osteotomy; metatarsal basal osteotomy

DOI：

10.7507/1002-1892.201906102

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Objective To evaluate the short-term effectiveness of the first ray tri-plane osteotomy and other metatarsal basal osteotomy in treatment of hallux valgus with moderate and severe metatarsus adductus.Methods Between February 2012 and September 2016, 10 patients (12 feet) of hallux valgus with moderate and severe metatarsus adductus were admitted and treated with the first ray tri-plane osteotomy and other metatarsal basal osteotomy and lateral soft tissue release. There were 1 male (2 feet) and 9 females (10 feet) with an average age of 34.5 years (range, 21-55 years). The disease duration ranged from 3 to 10 years (mean, 5.8 years). The degree of metatarsal adductus was moderate in 4 feet and severe in 8 feet according to modified Sgarlato measurement method. Preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was 46.4±9.3. The metatarsus adductus angle (MAA) was (25.41±3.66)°, hallux valgus angle (HVA) was (41.42±9.67)°, and the first-second intermetatarsal angle (1-2IMA) was (10.72±2.26)°.Results All incisions healed by first intention. All patients were followed up 18-24 months, with an average of 21.4 months. One patient (1 foot) had metastatic metatarsalgia after operation, but the symptoms disappeared after symptomatic treatment. X-ray re-examination showed that all osteotomies healed, and the healing time was 2.4-3.2 months, with an average of 2.8 months. At last follow-up, MAA was (8.42±0.71)°, HVA was (13.29±1.03)°, 1-2IMA was (4.41±0.48)°, and AOFAS score was 89.8±5.9. There were significant differences in clinical and radiographic indexes between pre- and post-operation (P<0.05).Conclusion The first ray tri-plane osteotomy combined with other metatarsal basal osteotomy has a significant short-term effectiveness in the treatment of hallux valgus with moderate and severe metatarsus adductus.

Citation： CHANG Xin, ZHANG Yunlong, YANG Jie, LI Yi, ZHANG Yan, WEN Xiaodong, LIANG Xiaojun. Short-term effectiveness of the first ray tri-plane osteotomy and other metatarsal basal osteotomy for hallux valgus with moderate and severe metatarsus adductus. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(1): 37-40. doi: 10.7507/1002-1892.201906102 Copy

1.	Aiyer A, Shub J, Shariff R, et al. Radiographic recurrence of deformity after hallux valgus surgery in patients with metatarsus adductus. Foot Ankle Int, 2015, 37(2): 165-171.
2.	王正义. 常见跖骨畸形的外科治疗. 中国骨与关节外科, 2012, 5(4): 295-301.
3.	Aiyer AA, Shariff R, Ying L, et al. Prevalence of metatarsus adductus in patients undergoing hallux valgus surgery. Foot Ankle Int, 2014, 35(12): 1292-1297.
4.	Coughlin MJ. Juvenile hallux valgus: etiology and treatment. Foot Ankle Int, 1995, 16(11): 682-697.
5.	Doody O, Hopper MA. Imaging of the foot and ankle. Orthopaedics and Trauma, 2014, 28(5): 339-349.
6.	Chen Li, Wang Chen, Wang Xu, et al. A reappraisal of the relationship between metatarsus adductus and hallux valgus. Chinese Medical Journal, 2014, 127(11): 2067-2072.
7.	Thomas JL, Kunkel MW, Lopez R, et al. Radiographic values of the adult foot in a standardized population. J Foot Ankle Surg, 2006, 45(1): 3-12.
8.	Dawoodi AI, Perera A. Reliability of metatarsus adductus angle and correlation with hallux valgus. Foot Ankle Surg, 2012, 18(3): 180-186.
9.	Chen L, Wang C, Wang X, et al. A reappraisal of the relationship between metatarsus adductus and hallux valgus. Chin Med J, 2014, 127(11): 2067-2072.
10.	Dawoodi AI, Perera A. Radiological assessment of metatarsus adductus. Foot Ankle Surg, 2012, 18(1): 1-8.
11.	Okuda R, Kinoshita M, Morikawa J, et al. Adult hallux valgus with metatarsus adductus: a case report. Clin Orthop Relat Res, 2002, (396): 179-183.
12.	蔡杰, 屈福锋, 刘培珑, 等. Scarf 截骨联合 Akin 截骨可吸收螺钉或金属螺钉固定治疗中重度踇外翻畸形疗效比较. 中国修复重建外科杂志, 2018, 32(11): 1386-1391.
13.	Smith BW, Coughlin MJ. Treatment of hallux valgus with an increased distal metatarsal articular angle: use of double and triple osteotomies. Foot Ankle Clin, 2009, 14(3): 369-382.
14.	Aronson J, Nguyen LL, Aronson EA. Early results of the modified Peterson bunion procedure for adolescent hallux valgus. J Pediatr Orthop, 2001, 21(1): 65-69.
15.	Choi YR, Lee HS, Jeong JJ, et al. Hallux valgus correction using transarticular lateral release with distal chevron osteotomy. Foot Ankle Int, 2012, 33(10): 838-843.
16.	Schneider W. Distal soft tissue procedure in hallux valgus surgery: biomechanical background and technique. Int Orthop, 2013, 37(9): 1669-1675.
17.	Park HW, Lee KB, Chung JY, et al. Comparison of outcomes between proximal and distal chevron osteotomy, both with supplementary lateral soft-tissue release, for severe hallux valgus deformity: A prospective randomised controlled trial. Bone Joint J, 2013, 95-B(4): 510-516.

1. Aiyer A, Shub J, Shariff R, et al. Radiographic recurrence of deformity after hallux valgus surgery in patients with metatarsus adductus. Foot Ankle Int, 2015, 37(2): 165-171.
2. 王正义. 常见跖骨畸形的外科治疗. 中国骨与关节外科, 2012, 5(4): 295-301.
3. Aiyer AA, Shariff R, Ying L, et al. Prevalence of metatarsus adductus in patients undergoing hallux valgus surgery. Foot Ankle Int, 2014, 35(12): 1292-1297.
4. Coughlin MJ. Juvenile hallux valgus: etiology and treatment. Foot Ankle Int, 1995, 16(11): 682-697.
5. Doody O, Hopper MA. Imaging of the foot and ankle. Orthopaedics and Trauma, 2014, 28(5): 339-349.
6. Chen Li, Wang Chen, Wang Xu, et al. A reappraisal of the relationship between metatarsus adductus and hallux valgus. Chinese Medical Journal, 2014, 127(11): 2067-2072.
7. Thomas JL, Kunkel MW, Lopez R, et al. Radiographic values of the adult foot in a standardized population. J Foot Ankle Surg, 2006, 45(1): 3-12.
8. Dawoodi AI, Perera A. Reliability of metatarsus adductus angle and correlation with hallux valgus. Foot Ankle Surg, 2012, 18(3): 180-186.
9. Chen L, Wang C, Wang X, et al. A reappraisal of the relationship between metatarsus adductus and hallux valgus. Chin Med J, 2014, 127(11): 2067-2072.
10. Dawoodi AI, Perera A. Radiological assessment of metatarsus adductus. Foot Ankle Surg, 2012, 18(1): 1-8.
11. Okuda R, Kinoshita M, Morikawa J, et al. Adult hallux valgus with metatarsus adductus: a case report. Clin Orthop Relat Res, 2002, (396): 179-183.
12. 蔡杰, 屈福锋, 刘培珑, 等. Scarf 截骨联合 Akin 截骨可吸收螺钉或金属螺钉固定治疗中重度踇外翻畸形疗效比较. 中国修复重建外科杂志, 2018, 32(11): 1386-1391.
13. Smith BW, Coughlin MJ. Treatment of hallux valgus with an increased distal metatarsal articular angle: use of double and triple osteotomies. Foot Ankle Clin, 2009, 14(3): 369-382.
14. Aronson J, Nguyen LL, Aronson EA. Early results of the modified Peterson bunion procedure for adolescent hallux valgus. J Pediatr Orthop, 2001, 21(1): 65-69.
15. Choi YR, Lee HS, Jeong JJ, et al. Hallux valgus correction using transarticular lateral release with distal chevron osteotomy. Foot Ankle Int, 2012, 33(10): 838-843.
16. Schneider W. Distal soft tissue procedure in hallux valgus surgery: biomechanical background and technique. Int Orthop, 2013, 37(9): 1669-1675.
17. Park HW, Lee KB, Chung JY, et al. Comparison of outcomes between proximal and distal chevron osteotomy, both with supplementary lateral soft-tissue release, for severe hallux valgus deformity: A prospective randomised controlled trial. Bone Joint J, 2013, 95-B(4): 510-516.

Chinese Journal of Reparative and Reconstructive Surgery

Short-term effectiveness of the first ray tri-plane osteotomy and other metatarsal basal osteotomy for hallux valgus with moderate and severe metatarsus adductus

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