The Early Results of Linear Distal Metatarsal Osteotomy with Minimal Incision for Correction of Hallux Valgus

무지 외반증의 교정에 있어 최소 절개를 이용한 원위 중족골 선상 절골술의 초기 수술 결과

Purpose: Good results using minimal invasive hallux valgus surgery has been reported recently. We evaluate the usefulness of linear distal metatarsal osteotomy with minimal skin incision in mild and moderate hallux valgus deformity. Materials and Methods: Twenty-eight patients (thirty-one cases) who had mild to moderate hallux valgus deformity and underwent linear distal metatarsal osteotomy using minimal skin incision were evaluated between February 2005 and February 2006. Hallux-metatarsophalangeal-interphalangeal scale of AOFAS (American Orthopaedic Foot and Ankle Society) score was used as clinical evaluation. Preoperative, postoperative, after pin removal, and final follow up plain radiographs were used as radiologic evaluation. Results: Twenty-six cases (83%) among thirty-one cases showed more than average satisfaction, Average AOFAS score were improved from 63.2 points (range 45-74 points) to 86.4 points (range 67-93 points). Preoperative radiologic index of IMA $14.0^{\circ}$ (range $10-18^{\circ}$), HVA $30.2^{\circ}$ (range $19-39^{\circ}$), DMAA $13.8^{\circ}$ (range $5-23^{\circ}$) were improved postoperatively as IMA $8.3^{\circ}$ (range $5-10^{\circ}$), HVA $10.5^{\circ}$ (range $2-20^{\circ}$), DMAA $7.2^{\circ}$ (range $0-14^{\circ}$) correctively. Mean operative time was 15.5 minutes (range 11-18 minutes) and mean operative time was 5.6 days (range 2-8 days). Conclusion: Despite small skin incision and short operative time and admission period, linear distal metatarsal osteotomy with minimal skin incision showed similar results with conventional distal metatarsal osteotomy. Thus, it was thought to be useful operation in mild and moderate hallux valgus deformity.