Modified Mau Osteotomy for the Treatment of Severe Hallux Valgus

중증 무지외반증에서 변형 Mau 절골술을 이용한 치료

Purpose: The purpose of this study was to evaluate the effect and short-term results of the modified Mau osteotomy designed by the author. Materials and Methods: Seventeen feet treated with newly designed osteotomy from 2003 to 2004 were included. We performed metatarsal osteotomy and distal soft tissue procedure on 17 feet (12 patients) and additional Akin osteotomy on 6 feet (4 patients). An oblique osteotomy was made from the neck in the dorsum, aiming proximal to the base of the first metatarsal with vertical short arm on the base. We performed long arm of osteotomy parellel to the acrylic plate which was supposed as ground plane. Preoperative radiographs and follow up radiographs at three month were used for radiologic evaluation. Results: Mean hallux valgus angle was $43.6^{\circ}$ and mean intermetatarsal angle was $20.4^{\circ}$ on preoperative weight bearing radiograph. Mean amount of correction of the hallux valgus angle was $37.5^{\circ}$ and intermetatarsal angle was $14.2^{\circ}$ at three months after operation. There was no fixation loss or malunion, and the clinical result was subjectively exellent. Conclusion: More proximal rotational axis can achieve sufficient intermetatarsal angle correction, and vertical arm can provide more stable contact. So this newly modified Mau osteotomy was considered as a good alternative procedure in the treatment of severe hallux valgus.

저자에 의해 개선된 변형 Mau 절골술은 우수한 교정력과 견고한 고정이 가능하면서도 술기가 간단하고 중족골두의 상하 전위가 없고 조기 보행이 가능한 안전한 방법이라 할 수 있었다. 따라서 향후 장기 추시가 필요하긴 하지만 중족골간각이 큰 중증의 무지외반증에서 추천할만한 좋은 방법으로 사료된다.