• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.81-86
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• 2005

Propose: This study was retrospectively to review the surgical results for moderate to severe hallux valgus corrected with a modified McBride procedure and proximal metatarsal crescentic osteotomy. Materials and Methods: Between August 1997 and August 2001, 15 patients with 22 bunion underwent surgical correction and were followed for an average 29.3 months (range, 18 to 53 months). Clinical results were evaluated with AOFAS clinical rating system for hallux and radiological measurements were done preoperatively and at a minimum of 12 months postoperatively. Results: The average AOFAS clinical rating score improved from 47.5 to 86.0. Union of the osteotomy site occurred at 9.5 weeks except one delayed union. The hallux valgus angle improved an from $36.5^{\circ}$ to $15.7^{\circ}$ and the intermetatarsal angle improved from $17.4^{\circ}$ to $8.6^{\circ}$ on average. Dorsiflexion of the first metatarsal at the osteotomy site was present in three (13.6%) with average $4^{\circ}$. Complications were two recurred deformity, one hallux varus and one painful transfer lesion. There was a high level of satisfaction with clinical results in 11 patients (73.3%) with 17 feets and cosmesis in 18 feets (81.8%). Conclusion: Modified McBride procedure and proximal metatarsal crescentic osteotomy based on careful patient selection and meticulous technique showed satisfactory outcome for moderate to severe hallux valgus.

• Journal of Korean Foot and Ankle Society
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• v.17 no.3
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• pp.225-233
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• 2013

Purpose: This study was performed to evaluate the impact of the lesser toe operation on the overall clinical outcomes, and to analyze the clinical results of concomitant surgery for hallux valgus and lesser toe deformities. Materials and Methods: Forty-six cases underwent surgery for hallux valgus with concomitant lesser toe deformities were followed up for at least 1 year. Lesser toe deformities consisted of 9 crossover toes, 10 claw toes, 12 hammer toes and 15 bunionettes. Clinical evaluation was performed according to AOFAS (American Orthopaedic Foot and Ankle Society) score, patient's satisfaction score, and pain VAS (visual analogue scale) score. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and period to union were measured. Preoperative expectation about lesser toe deformities, postoperative satisfaction, complication rate, hospitalization period, medical expenses, and frequency of outpatient follow-up were analyzed. Results: AOFAS score, VAS score, HAV and IMA had improved significantly. On preoperative expectation of patients, correction of lesser toe deformities was ranked third, following the improvement of big toe(bunion) pain and the correction of hallux valgus. Patient's satisfaction score was average 92.8 points, and the importance of lesser toe operation was 30.2%. When compared to hallux valgus operation only, there were average 2.5 days of additional hospitalization, 2.4 times of additional outpatient follow-up, 386000 won of additional medical expenses. Conclusion: Combined operation for hallux valgus and concomitant lesser toe deformities showed good clinical results. When compared to hallux valgus operation only, there were longer hospitalization, more frequent follow-up, more medical expenses, more complications. However, lesser toe deformity correction in patients underwent hallux valgus operation is considerable, because of high preoperative expectation and postoperative satisfaction.

• Journal of Korean Foot and Ankle Society
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• v.25 no.4
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• pp.157-164
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• 2021

Purpose: This study aimed to report the current trends in the management of the hallux valgus (HV) deformity over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experience in correction in patients with an HV deformity. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: One hundred and nine (19.8%) of the 550 members responded to the survey. The most common symptom for determining surgical treatment was bunion pain (68.8%), and different surgical techniques were selected according to the following radiological parameters: HV angle 30 to 40 degrees and intermetatarsal angle 15 to 20 degrees. The two procedures most preferred by the respondents were distal chevron osteotomy (55.0%), and proximal chevron osteotomy (21.1%). In an average of 71.6% of respondents, Arkin osteotomy was performed simultaneously during HV surgery. HV accompanied by an overriding deformity of the second toe was most often addressed with a combination of second metatarsal osteotomy and soft tissue rebalancing procedure (35.8%). After HV surgery, the recurrence rate of HV deformity was found to be 12.2% on average and the surgeons who had performed minimally invasive surgery (MIS) for HV comprised 34.9% of the total respondents. Conclusion: This study provides updated information on the current trends in the management of the HV deformity in Korea. Both consensus and variation in the approach to patients with HV were identified by this survey study. Although MIS for HV has increased, it appears the consensus for selecting this method has not yet been established.