Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Treatment of Severe Hallux Valgus Deformity with Proximal Reverse Chevron Metatarsal Osteotomy and Akin Osteotomy

고도의 무지 외반증에서 역갈매기형 중족골 절골술 및 Akin 절골술의 치료

  • Jung, Hong-Geun (Department of Orthopaedic Surgery, Konkuk University Medical Center) ;
  • Oh, Jeong-Hwan (Department of Orthopaedic Surgery, Konkuk University Medical Center) ;
  • Kim, Tae-Hoon (Department of Orthopaedic Surgery, Konkuk University Medical Center) ;
  • Park, Jae-Yong (Department of Orthopaedic Surgery, Konkuk University Medical Center) ;
  • Kang, Min-Seok (Department of Orthopaedic Surgery, Konkuk University Medical Center)
  • 정홍근 (건국대학교 의학전문대학원 정형외과학교실) ;
  • 오정환 (건국대학교 의학전문대학원 정형외과학교실) ;
  • 김태훈 (건국대학교 의학전문대학원 정형외과학교실) ;
  • 박재용 (건국대학교 의학전문대학원 정형외과학교실) ;
  • 강민석 (건국대학교 의학전문대학원 정형외과학교실)
  • Received : 2010.04.19
  • Accepted : 2010.05.13
  • Published : 2010.06.15
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Abstract

Purpose: This study analyzed the clinical and radiographic outcome of the severe hallux valgus corrected with proximal reverse chevron metatarsal osteotomy and Akin osteotomy. Materials and Methods: The study was based on 18 feet (15 patients) of severe hallux valgus (hallux valgus angle ${\geq}40^{\circ}$ or intermetatarsal angle ${\geq}18^{\circ}$) treated with proximal reverse chevron metatarsal osteotomy and followed for more than 1 year. Akin osteotmy was added in 72% of the patients. Clinically preoperative and postoperative AOFAS Hallux Metatarsophalangeal-interphalangeal score, VAS pain score and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. Results: AOFAS Hallux Metatarsophalangeal-interphalangeal score improved from 54.5 (25-78) to 87.7 (70-100) and VAS pain score decreased from 6.0 (3-8) to postoperative 1.2 (0-5). Ninety-six percents of the patients were satisfied with results. Radiologically hallux valgus angle was decreased from $43.3^{\circ}(31-58^{\circ})$ preoperatively to $6.8^{\circ}(-8-27^{\circ})$ postoperatively. The intermetatarsal angle was decreased from $18.4^{\circ}(11-24)^{\circ}$ preoperatively to $5.3^{\circ}(1-12^{\circ})$postoperatively. The sesamoid subluxation was improved from $2.8{\pm}0.4$ preoperatively to $0.4{\pm}0.6$ postoperatively. Conclusion: Proximal reverse chevron metatarsal osteotomy and lateral soft tissue release with additional Akin osteotomy is good treatment option for severe hallux valgus.

Keywords

References

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