• Journal of Korean Foot and Ankle Society
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• v.5 no.2
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• pp.149-155
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• 2001

Purpose: To evaluate the clinical results of Mitchell osteotomy and proximal metatarsal dome osteotomy in hallux valgus deformity. Materials and Methods: From January 1993 to June 2000, 28 cases (17 patients) with hallux valgus deformity who underwent Mitchell osteotomy were categorized as group I, 26 cases (16 patients) who underwent proximal metatarsal dome osteotomy were categorized as group II. We analyzed clinical results according to preoperative and postoperative clinical functional analysis and objective comparison of correction angle between two groups. Results: The average hallux valgus correction in the Mitchell osteotomy group went from $36^{\circ}$ to $11^{\circ}$, and in the proximal metatarsal dome osteotomy group, the hallux valgus angle was reduced from $32^{\circ}$ to $6^{\circ}$. The intermetatarsal angle in the Mitchell osteotomy group was corrected from $13^{\circ}$ to $9^{\circ}$, and in the proximal metatarsal dome osteotomy group the intermetatarsal angle was reduced from $14^{\circ}$ to $7^{\circ}$. Although, proximal metatarsal dome osteotomy group have shown better correction angle and radiographic results in the correction of hallux valgus angle and intermetatarsal angle but, all patients in the Mitchell osteotomy and proximal metatarsal dome osteotomy groups had no statistically significant differences of clinical functional results between two groups. Conclusion: In our studies, the proximal metatarsal dome osteotomy applied to. hallux valgus deformity was found as a good radiographic results than Mitchell osteotomy, but there were no differences between the two operations in terms of functional satisfaction.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.174-178
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• 2003

Purpose: The purpose of this study was to evaluate the radiographic results and complications after the proximal dome osteotomy for hallux valgus. Material and Methods: 127 cases of clinically moderate to severe hallux valgus from October 1994 to September 1997 were included in this study. All had been surgically corrected with proximal dome osteotomy, bunionectomy, and distal soft tissue release. We compared the hallux valgus angle(HVA) and intermetatarsal angle(IMA) at preoperative, postoperative 3 weeks, postoperative 6 weeks, and postoperative 3 months. Also we reviewed the postoperative com plications. Result: The HVA averaged $34.1^{\circ}$ at preoperative, $4.3^{\circ}$ at 3 weeks after operation, $8.1^{\circ}$ at 6 weeks after operation, and $10.2^{\circ}$ at 3 months after operation. The lMA averaged $14.6^{\circ}$ at preoperative, $5.1^{\circ}$ at 3 weeks after operation, $5.6^{\circ}$ at 6 weeks after operation, and $7.3^{\circ}$ at 3 months after operation. We experienced 7 cases of malunion, 5 cases of limitation of motin at the first metatarso-phalangeal joint, 3 cases of hallux varus deformity, 2 cases of delayed union. Conclusion: Proximal dome osteotomy for moderate to severe hallux valgus deformity was considered as one of the effective treatment methods. And we try to avoid limitation of motion at the first metatarso-phalangeal joint after operation.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.121-125
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• 2004

Purpose: We try to retrospectively evaluated the amount of dorsal angulation angle of the first metatarsal commonly occurring as the complication of proximal dome osteotomy for hallux valgus. Materials and Methods: Between January 2004 and March 2004, 34 patients who underwent proximal dome osteotomy for moderate to severe hallux valgus. Two of 34 patients were male, and thirty-two were female. The average age was 57.6 years. We measured and compared hallux valgus angle, 1st-2nd intermetatarsal angle, dorsal angulation angle of 1st metatarsal on preoperative, postoperative, postoperative 3 weeks', postoperative 3 months' X-ray. Results: Osteotomy sites were completely united on plane X-ray in all cases. The hallux valgus angle averaged $41.2^{\circ}$ ($30{\sim}60^{\circ}$) at preoperative, $4.3^{\circ}$ ($-10{\sim}20^{\circ}$) at postoperative, $5.5^{\circ}$ ($-1{\sim}20^{\circ}$) at 3 weeks after operation, $7.8^{\circ}$ ($-2{\sim}20^{\circ}$) at 3 months after operation. The 1st-2nd intermetatarsal angle averaged $17.1^{\circ}$ ($12{\sim}24^{\circ}$) at preoperative, $6.3^{\circ}$ ($0{\sim}13^{\circ}$) at postoperative, $7.2^{\circ}$ ($0{\sim}15^{\circ}$) at 3 weeks after operation, $8.7^{\circ}$ ($0{\sim}18^{\circ}$) at 3 months after operation. The dorsal angulation angle averaged $0.4^{\circ}$ ($0{\sim}3^{\circ}$) at postoperative, $1.6^{\circ}$ ($0{\sim}7^{\circ}$) at 3 weeks after operation, $2.1^{\circ}$ ($0{\sim}8^{\circ}$) at 3 months after operation. There were no statistically correlation between increase of dorsal angulation angle of the distal segment of the first metatarsal and increase of hallux valgus angle or 1st-2nd intermetatarsal angle. Conclusion: Our results shows that the dorsal angulation of distal fragment occurring after the proximal dome osteotomy in the treatment of hallux valgus may be minimized with meticulous surgery and patient's education.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.2
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• pp.106-111
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• 2000

Focal fibrocartilaginous dysplasia(FFCD) is an uncommon, benign condition associated with unilateral tibia vara among young children. FFCD has a typical plain radiographic finding, which has a concave radiolucent defect in the metadiaphyseal junction of medial aspect of the proximal tibia. The varus deformity occurs at the site of the lesion. Spontaneous remodeling and resolution of bony defect may be expected, but the corrective osteotomy may also be needed in some cases. The authors described a case of unilateral tibia vara caused by FFCD, diagnosed by excisional biopsy and treated with dome-shaped proximal tibial osteotomy and bone graft.