PURPOSE: The authors intended to analyze the operative results of moderate hallux valgus with proximal chevron metatarsal osteotomy and distal soft tissue procedure. MATERIALS AND METHODS: Seventy feet of fifty-seven patients were followed for more than 1 year after the proximal chevron metatarsal osteotomy. The mean age was 47.2 years, and the mean follow up period was 2 years and 3 months. Clinically preoperative and postoperative AOFAS MP-IP scale 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: Additional Akin osteotomy was performed 48 out of 70 feet. Clinically AOFAS MP-IP scale was increased from 60.4 points preoperatively to 89.8 points postoperatively. Ninety-four percents of the patients were satisfied with the results. Radiologically hallux valgus angle was decreased from 34.8 degrees preoperatively to 12.8 degrees postoperatively. The intermetatarsal angle was decreased from 15.7 degrees preoperatively to 8.0 degrees postoperatively. Hallux valgus interphalangeal angle was increased from 7.4 degrees preoperatively to 9.8 degrees postoperatively. There were 3 recurrences, 1 hallux varus and 3 minor wound infections. There were no nonunion or malunion of the 1st metatarsal. CONCLUSION: Proximal chevron metatarsal osteotomy with distal soft tissue procedure and additional Akin osteotomy appears to be safe and satisfactory procedure.
Follow-Up Studies ; Foot ; Hallux Valgus* ; Hallux Varus ; Hallux* ; Humans ; Metatarsal Bones* ; Osteotomy* ; Recurrence ; Wound Infection

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 degrees to 15.7 degrees and the intermetatarsal angle improved from 17.4 degrees to 8.6 degrees on average. Dorsiflexion of the first metatarsal at the osteotomy site was present in three (13.6%) with average 4 degrees. 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.
Congenital Abnormalities ; Foot ; Hallux Valgus* ; Hallux Varus ; Hallux* ; Humans ; Metatarsal Bones* ; Osteotomy* ; Patient Selection ; Retrospective Studies

In general, the operative treatment of the brachymetatarsia is the lengthening of the affected metatarsal bone due to the cosmetic problem rather than the functional one. We experienced 22 year-old female bilateral congenital foot deformities such as hallux varus and 1,4th brachymetatarsia treated with reverse Scarf osteotomy on the hallux varus and massive axial metatarsal shortening Weil osteotomy on the 2,3,5th metatarsals which could reconstruct the normal metatarsal parabola.
Callosities ; Cosmetics ; Female ; Foot Deformities, Congenital ; Hallux ; Hallux Varus ; Humans ; Metatarsal Bones ; Osteotomy

The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, 4th extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using 4th extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.
Athletes ; Collateral Ligaments ; Hallux ; Hallux Varus ; Humans ; Joints ; Metatarsophalangeal Joint ; Military Personnel ; Tendons

PURPOSE: The purpose of the present study is to evaluate the proximal metatarsal chevron osteotomy outcomes for moderate to severe hallux valgus more than seven year follow up. MATERIALS AND METHODS: Between 1996 and 1998, hallux valgus 61 cases were evaluated. The follow up period was more than seven years. The clinical review analyzed by the hallux metatarsophalangeal-interphalangeal scale of the American Orthopedic Foot and Ankle Society, radiologic review by the hallux valgus angle, first and second intermetatarsal angle. Complication also evaluated. RESULTS: Clinically, preoperative AOFAS score was average 43 points (range; 16~60 points) which significantly improved to 88 points (range; 61~100 points) at last follow up periods. Radiologically, the mean preoperative, postoperative, last follow up hallux valgus angle was 34 degrees, 5.2 degrees, 10.9 degrees. The mean preoperative, postoperative, last follow up intermetatarsal angle was 15.3 degrees, 3.3 degrees, 5.3 degrees. Postoperative angle change were no statistical significance (p>0.05). Complication were hallux varus 6 cases, metatarsophalangeal joint arthritis 2 cases, recurrence 1 case. CONCLUSION: Proximal metatarsal chevron osteotomy shows satisfactory outcome for moderate to severe hallux valgus more than seven year follow up.
Ankle ; Arthritis ; Follow-Up Studies* ; Foot ; Hallux Valgus* ; Hallux Varus ; Hallux* ; Metatarsal Bones* ; Metatarsophalangeal Joint ; Orthopedics ; Osteotomy* ; Recurrence

PURPOSE: The objective of this study was to confirm the results of the modified Lapidus procedure on moderate to severe hallux valgus patients with first tarso-metatarsal joint hypermobility. MATERIALS AND METHODS: A retrospective study was conducted on 42 cases of 35 patients who underwent the modified Lapidus procedure between March 2006 and December 2014. A comparative analysis was performed on the preoperative and postoperative subjective satisfaction of patients and radiologic index. Moreover, the correlation between the follow-up time and patient's operative satisfaction, as well as between the proficiency of the operator and patient's operative satisfaction was analyzed. Complications were also evaluated. RESULTS: Out of the total of 35 patients, 3 were male and 32 were female. The mean age was 61.3 years (range, 34∼79 years), and the mean follow-up time was 22.1 months (range, 6∼90 months). The overall satisfaction level was 67.6% and the mean hallux valgus angle improved from preoperative 40.5° to postoperative 12.2° (p<0.001). The mean 1, 2 intermetatarsal angle improved from preoperative mean of 16.9° to postoperative mean of 7.6° (p<0.001), and the sesamoid position improved significantly, from preoperative 2.7 to postoperative 0.9 (p<0.001). Furthermore, there was no correlation between the follow-up time and the American Orthopaedic Foot and Ankle Society (AOFAS) hallux scale; also no correlation between the year the operation took place and the AOFAS hallux scale. In terms of complications, we observed screw irritation in 6 cases, hallux varus in 2 cases, and recurrence of hallux valgus and nonunion in one case. CONCLUSION: Contrary to our concerns, the level of complications was not high; however, the satisfaction level of patients was also not very high. Therefore, careful selecting of patients and sufficient consultation time is needed before surgery. In addition, since the causes of postoperative dissatisfaction still remain unclear, further studies are necessary.
Ankle ; Female ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Hallux Varus ; Hallux* ; Humans ; Joint Instability* ; Joints* ; Male ; Recurrence ; Retrospective Studies

The goal of surgical correction for hallux valgus is to achieve a painless, shoe-wearable, and relatively straight toe with a balanced joint motion that results in aesthetically and functionally satisfactory toe. To date, there has not been a consensus on the ultimate surgical procedure for hallux valgus correction. Unfortunately, such a consensus may be difficult since it is not uncommon to encounter complications after hallux valgus correction. Postoperative soft tissue complications include difficult wound healing, infection, hypertrophy, or pain of the scar, joint stiffness, and tendon or sensory nerve damage. Postoperative bony complications include malunion, nonunion, failure of fixation, failure of angle correction, recurred deformity, osteomyelitis, and failure of balance between the metatarsal heads. Herein, we review common complications after surgical correction of hallux valgus, such as stiff joint, bony complications, recurrence of the deformity, and hallux varus.
Cicatrix ; Congenital Abnormalities ; Consensus ; Hallux Valgus* ; Hallux Varus ; Hallux* ; Head ; Hypertrophy ; Joints ; Metatarsal Bones ; Osteomyelitis ; Recurrence ; Tendons ; Toes ; Wound Healing

BACKGROUND: The purpose of this study was to report outcomes of congenital hallux varus deformity after surgical treatment. METHODS: We evaluated ten feet of eight patients with a congenital hallux varus deformity, including four feet combined with a longitudinal epiphyseal bracket (LEB). There were seven male patients and one female patient with a mean age of 33 months (range, 7 to 103 months) at the time of surgery. Two patients were bilaterally involved. The mean duration of follow-up was 5.9 years (range, 2.3 to 13.8 years). Clinical outcomes were assessed according to the criteria of Phelps and Grogan. Surgical procedures included the Farmer procedure, the McElvenny procedure or an osteotomy at the first metatarsal or proximal phalanx. RESULTS: The clinical results were excellent in two feet, good in six and poor in two feet. The LEB was associated with hallux varus in four feet and were treated by osteotomy alone or in conjunction with soft tissue procedure. CONCLUSIONS: Congenital hallux varus was successfully corrected by surgery with overall favorable outcome. Preoperatively, a LEB should be considered as a possible cause of the deformity in order to prevent recurrent or residual varus after surgery.
Child ; Child, Preschool ; Female ; Foot Deformities, Congenital/radiography/*surgery ; Hallux Varus/radiography/*surgery ; Humans ; Infant ; Male ; Osteotomy

PURPOSE: To evaluate patient characteristics such as deformity type, associated disease, and family history, and results of treatment of pre-axial polydactyly with hallux varus deformity. MATERIALS AND METHODS: We carried out a retrospective study of 5 patients who presented with preaxial polydactyly with hallux varus deformity, and were treated between 2003 and 2010 at the authors' hospital. Surgeries including extra digit excision, local flap, osteotomy, and interphalangeal joint fusion were performed taking into consideration the deformity types and patient's age. Family history, associated disease, and types of duplication were assessed, and the outcomes of surgery were evaluated with radiographs and appearances of foot. The mean follow-up period was 34 months. RESULTS: All 5 patients had one or more associated anomalies such as congenital anterolateral tibial bowing and polydactyly in three, translocation of chromosome 2 : 13 associated with cryptorchidism in one, pes planovalgus in one, residual poliomyelitis in one, syndactyly of the foot in two, and leg length discrepancy in one patient. There was no family history of hallux polydactyly in any of the cases. All five patients had duplication of the distal phalanx and one of them had a blocked proximal phalanx. The extra digit was completely removed and the varus deformity was corrected in all cases. CONCLUSION: There was a high incidence of associated diseases in patients with hallux polydactyly and varus deformity. Deformity correction could be obtained by surgeries chosen according to the individual deformity type and patient age.
Chromosomes, Human, Pair 2 ; Congenital Abnormalities ; Cryptorchidism ; Follow-Up Studies ; Foot ; Hallux ; Hallux Varus ; Humans ; Incidence ; Joints ; Leg ; Male ; Osteotomy ; Poliomyelitis ; Polydactyly ; Retrospective Studies ; Syndactyly

BACKGROUND: Free fat graft has been used for the treatment of congenital hand differences. However, there have been a few reports about the outcome of that treatment. In this study, the outcome of free fat grafts for congenital hand and foot differences was investigated. METHODS: Fourteen bones with longitudinal epiphyseal bracket, 3 wrists with Madelung deformity, and 5 cases of osseous syndactyly were treated with free fat graft with osteotomy, physiolysis, or separation of osseous syndactyly. Of the fourteen bones with longitudinal epiphyseal bracket, 9 were treated with open wedge osteotomy with free fat graft and 5 with physiolysis and free fat graft. The Madelung deformity was treated with physiolysis with free fat graft. For osseous syndactyly, syndactyly release with free fat graft was performed five times on four hands. RESULTS: In the fourteen cases with longitudinal epiphyseal bracket, lateral deviation improved in all except two cases after surgery. The average lateral deviation angle changed from 32.5 degrees before surgery to 15.2 degrees after surgery. The average improvement of the lateral deviation angle was 12.2 degrees in the osteotomy group and 20.6 degrees in the physiolysis group. The mean ratio of improvement of the lateral deviation angle to the lateral deviation angle before surgery was 39.4% in the osteotomy group and 51.2% in the physiolysis group. The Madelung deformity improved after surgery in two cases but there was no improvement in one case. For these conditions, the results were not good enough when surgery was done after age 13 or at age four for severely hypoplastic brachymesophalangy. Of the 5 cases of osseous syndactyly, reunion of the separated bones occurred in one case. The grafted free fat should be deep enough to cover the osteotomy site of the bones to prevent reunion of the separated bones. CONCLUSIONS: Physiolysis and free fat graft performed during the growth period can correct the deviation due to longitudinal epiphyseal bracket and Madelung deformity. Free fat graft is also useful to prevent reunion of the bones after separation of osseous syndcatyly, if the grafted fat is securely filled into the space between the separated bones.
Adipose Tissue/*transplantation ; Adolescent ; Child ; Child, Preschool ; Female ; Fingers/*abnormalities/surgery ; Foot Deformities, Congenital/surgery ; Hallux Varus/surgery ; Hand Deformities, Congenital/*surgery ; Humans ; Male ; Osteotomy ; Statistics, Nonparametric ; Syndactyly/*surgery ; Treatment Outcome