DOI QR코드

DOI QR Code

Treatment of Bunionette Deformity with Diaphyseal Oblique Osteotomy

간부 사형 절골술을 이용한 소건막류의 수술적 치료

  • Kim, Sang Kil (Department of Orthopaedic Surgery, Seoul National University Boramae Medical Center) ;
  • Kim, Jihyeung (Department of Orthopaedic Surgery, Seoul National University Boramae Medical Center) ;
  • Lee, Jeong Ik (Department of Orthopaedic Surgery, Seoul National University Boramae Medical Center) ;
  • Rhee, Seung Hwan (Department of Orthopaedic Surgery, Seoul National University Boramae Medical Center)
  • 김상길 (서울대학교 보라매병원 정형외과) ;
  • 김지형 (서울대학교 보라매병원 정형외과) ;
  • 이정익 (서울대학교 보라매병원 정형외과) ;
  • 이승환 (서울대학교 보라매병원 정형외과)
  • Received : 2014.01.12
  • Accepted : 2014.02.03
  • Published : 2014.03.15

Abstract

Purpose: The purpose of this study is to evaluate the clinical and radiographic results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. Materials and Methods: We retrospectively reviewed 12 feet of nine patients diagnosed as symptomatic bunionette and treated with diaphyseal oblique osteotomy. All patients were female and the average age at the time of surgery was 48 years. We checked the foot standing anteroposterior, oblique, and lateral images pre- and post-operatively. We measured the fourth intermetatarsal angle and fifth metatarsophalangeal angle and evaluated the clinical results using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scale preoperatively and six months postoperatively. Results: Of the nine patients, hallux valgus was combined with symptomatic bunionette in seven feet of five patients. In all of our cases, the average AOFAS lesser MTP-IP scale showed improvement after surgery. Painful callosity around the fifth metatarsophalangeal joint disappeared after surgery in all of our cases. The fourth intermetatarsal angle improved from $12.7^{\circ}$ to $3.1^{\circ}$ and the fifth metatarsophalangeal angle improved from $16.6^{\circ}$ to $2.3^{\circ}$. Conclusion: Diaphyseal oblique osteotomy of the fifth metatarsal appears to be a safe and satisfactory surgical procedure for treatment of symptomatic bunionette.

Keywords

References

  1. Buchbinder IJ. DRATO procedure for tailor's bunion. J Foot Surg. 1982;21:177-80.
  2. Diebold PF, Bejjani FJ. Basal osteotomy of the fifth metatarsal with intermetatarsal pinning: a new approach to tailor's bunion. Foot Ankle. 1987;8:40-5. https://doi.org/10.1177/107110078700800109
  3. Coughlin MJ. Etiology and treatment of the bunionette deformity. Instr Course Lect. 1990;39:37-48.
  4. Koti M, Maffulli N. Bunionette. J Bone Joint Surg Am. 2001;83: 1076-82. https://doi.org/10.2106/00004623-200107000-00016
  5. Davies H. Metatarsus quintus valgus. Br Med J. 1949;1:664.
  6. Brown JE. Functional and cosmetic correction of metatarsus latus (splay foot). Clin Orthop. 1959;14:166-70.
  7. Sgarlato TE. A compendium of podiatric biomechanics. San Francisco: California College of Podiatric Medicine; 1971. 381-96.
  8. Yancey HA Jr. Congenital lateral bowing of the fifth metatarsal. Report of 2 cases and operative treatment. Clin Orthop Relat Res. 1969;62:203-5.
  9. Kitaoka HB, Holiday AD Jr. Lateral condylar resection for bunionette. Clin Orthop Relat Res. 1992;(278):183-92.
  10. Steinke MS, Boll KL. Hohmann-Thomasen metatarsal osteotomy for tailor's bunion (bunionette). J Bone Joint Surg Am. 1989;71 : 423-6. https://doi.org/10.2106/00004623-198971030-00018
  11. Haber JH, Kraft J. Crescentic osteotomy for fifth metatarsal head lesions. J Foot Surg. 1980;19:66-7.
  12. Leach RE, Igou R. Metatarsal osteotomy for bunionette deformity. Clin Orthop Relat Res. 1974;(100):171-5.
  13. Sponsel KH. Bunionette correction by metatarsal osteotomy: preliminary report. Orthop Clin North Am. 1976;7:809-19.
  14. Coughlin MJ. Treatment of bunionette deformity with longitudinal diaphyseal osteotomy with distal soft tissue repair. Foot Ankle. 1991;11:195-203. https://doi.org/10.1177/107110079101100402
  15. London BP, Stern SF, Quist MA, Lee RK, Picklesimer EK. Long oblique distal osteotomy of the fifth metatarsal for correction of tailor's bunion: a retrospective review. J Foot Ankle Surg. 200 3; 42:36-42. https://doi.org/10.1016/S1067-2516(03)70051-9
  16. Ahn JH, Kim HY, Kang JW, Choy WS, Kim YI. Treatment of bunionette deformity with diaphyseal oblique osteotomy. J Korean Foot Ankle Soc. 2008;12:31-5.
  17. Diebold PF. Basal osteotomy of the fifth metatarsal for the bunionette. Foot Ankle. 1991;12:74-9. https://doi.org/10.1177/107110079101200203
  18. McKeever DC. Excision of the fifth metatarsal head. Clin Orthop Relat Res. 1959;13:321-2.
  19. Fallat LM, Buckholz J. An analysis of the tailor's bunion by radiographic and anatomical display. J Am Podiatry Assoc. 1980;70: 597-603. https://doi.org/10.7547/87507315-70-12-597
  20. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349-53. https://doi.org/10.1177/107110079401500701
  21. Schoenhaus H, Rotman S, Meshon AL. A review of normal intermetatarsal angles. J Am Podiatry Assoc. 1973;63:88-95. https://doi.org/10.7547/87507315-63-3-88
  22. Steel MW 3rd, Johnson KA, DeWitz MA, Ilstrup DM. Radiographic measurements of the normal adult foot. Foot Ankle. 1980;1:151-8. https://doi.org/10.1177/107110078000100304
  23. Gerbert J, Sgarlato TE, Subotnick SI. Preliminary study of a closing wedge osteotomy of the fifth metatarsal for correction of a tailor's bunion deformity. J Am Podiatry Assoc. 1972;62:212-8. https://doi.org/10.7547/87507315-62-6-212
  24. Nestor BJ, Kitaoka HB, Ilstrup DM, Berquist TH, Bergmann AD. Radiologic anatomy of the painful bunionette. Foot Ankle. 1990; 11:6-11. https://doi.org/10.1177/107110079001100102
  25. Fallat LM. Pathology of the fifth ray, including the tailor's bunion deformity. Clin Podiatr Med Surg. 1990;7:689-715.
  26. Mann RA, Mann JA. The bunionette deformity. Instr Course Lect. 2004;53:303-9.
  27. Cohen BE, Nicholson CW. Bunionette deformity. J Am Acad Orthop Surg. 2007;15:300-7. https://doi.org/10.5435/00124635-200705000-00008

Cited by

  1. 소건막류에서 경피적 절골술의 전위 정도가 임상 결과에 미치는 영향 vol.19, pp.2, 2014, https://doi.org/10.14193/jkfas.2015.19.2.63
  2. 소건막류의 원위부 역위 사형 절골술 후 체중부하의 효과 vol.20, pp.4, 2014, https://doi.org/10.14193/jkfas.2016.20.4.158