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hallux abductovalgus

Steven M Douthett, Nathan K Plaskey, Lawrence M Fallat, John Kish
Hallux abductovalgus is one of the most common deformities addressed by foot and ankle surgeons. Surgically, it can be approached using a wide variety of procedures. After performing the first metatarsal osteotomy, the final step is often to realign the great toe in a rectus position. This is performed with an osteotomy of the proximal phalanx. The Akin osteotomy is a medially based closing wedge osteotomy of the proximal phalanx. When executing the osteotomy, the goal is not only to correct abduction, but also to keep the lateral cortex intact, which allows it to act as an additional point of fixation...
January 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Eric A Barp, John G Erickson, Hayden L Smith, Katrina Almeida, Kelsey Millonig
First metatarsocuneiform joint arthrodesis has been used in foot and ankle surgery for the treatment of hallux abductovalgus deformity, among other pedal pathologic entities. The goal of the present retrospective study was to compare the fusion rates and complications of an intraplate compression screw fixation, crossing solid core screw fixation, and a single interfragmentary screw with a simple locking plate. All procedures were performed by a single surgeon, and all patients received an identical postoperative protocol...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Alireza Khosroabadi, Bradley M Lamm
Percutaneous surgical techniques and minimally invasive procedures in foot and ankle surgery are gaining interest for both patients and surgeons. Percutaneous surgery is defined by a soft tissue or osseous procedure performed through the smallest possible incision without direct visualization of the underlying target structures. Percutaneous surgery has many potential advantages, including quicker operative times, multiplanar osteotomy correction, smaller incisions, decreased scarring, lower complication rates, and faster recovery times...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Andrew J Meyr, Salil Singh, Oliver Chen, Sayed Ali
This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for the hallux abductovalgus or "bunion" deformity. Our goal is to define objective radiographic parameters that surgeons utilize to initially define deformity, lead to procedure selection and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries. First, relevant radiographic measurements are defined and their role in procedure selection explained...
June 2015: Journal of Radiology Case Reports
Bradley M Lamm, Jacob Wynes
A common surgical treatment of severe hallux abductovalgus deformity with coincident first ray hypermobility is metatarsal-cuneiform fusion or Lapidus procedure. The aim of the present study was to illustrate a reliable and novel method of fixation for Lapidus fusion using an external fixation device through a retrospective cohort investigation of consecutive patients. Twenty Lapidus fusions were performed in 19 patients, including 17 females (89.47%) and 2 males (10.53%). The mean age at surgery was 41 (range 20 to 64) years...
September 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
L Mae Chandler
An array of distal first metatarsal osteotomies has been described over the decades for the correction of hallux valgus. No one procedure is proficient in correcting all forms and severities of hallux valgus deformities. To optimize results, it is imperative for the surgeon to match a procedure and its modifications to the patient's deformity. The dorsal long arm chevron osteotomy stands at the forefront for correction of mild to moderate hallux abductovalgus. The results with this specific osteotomy are predictable; it allows for early ambulation, and it is easily modified to compensate for the deformity at hand...
April 2014: Clinics in Podiatric Medicine and Surgery
David Rettedal, Nicholas J Lowery
The primary indication for an osteotomy of the hallux proximal phalanx to correct hallux abductovalgus (HAV) deformities is increased hallux interphalangeus. The typical osteotomy is the Akin osteotomy or a variation. The Akin is a medial closing wedge osteotomy in the proximal phalanx. An Akin-type osteotomy is usually used as an adjunctive procedure for HAV to correct deformity within the great toe. When first metatarsal procedures and soft tissue balancing are not sufficient for realigning the first metatarsophalangeal joint, an Akin can be useful...
April 2014: Clinics in Podiatric Medicine and Surgery
Patrick R Burns, Brandon Mecham
Hallux abductovalgus (HAV) is a common but complex deformity. HAV is a combination of deformities and abnormalities. Because HAV is not from a single cause or pathologic process, controversies in description and potential treatments exist. Although many HAV deformities appear similar, no two are the same and thus cannot be treated the same surgically.
April 2014: Clinics in Podiatric Medicine and Surgery
Tanujan Thangarajah, Usman Ahmed, Shahbaz Malik, Abhay Tillu
Hallux valgus is one of the commonest conditions of the foot and has been reported to affect nearly half of the adult population. It is most effectively treated by a corrective osteotomy of which there a numerous subtypes. The Mau osteotomy confers the greatest structural stability but is not thought to provide adequate correction of moderate-severe deformities. Accordingly, complications such as under correction and non-union are common. The aim of this study was to determine the functional outcome in patients with moderate-severe hallux valgus following a Mau osteotomy...
2013: Orthopedic Reviews
Ryan M Murphy, Lawrence M Fallat, John P Kish
The distal chevron osteotomy is a widely accepted technique for the treatment of hallux abductovalgus deformity. Although the osteotomy is considered to be stable, displacements of the capital fragment has been described. We propose a new method for fixation of the osteotomy involving the axial loading screw (ALS) used in addition to single screw fixation. We believe this method will provide a more mechanically stable construct. We reviewed the charts of 46 patients in whom 52 feet underwent a distal chevron osteotomy that was fixated with either 1 screw or 2 screws that included the ALS...
January 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Andrew J Meyr, Adam Myers, Jane Pontious
Although the transverse plane radiographic parameters of the first intermetatarsal angle (IMA), hallux abductus angle (HAA), and the metatarsal-sesamoid position (MSP) form the basis of preoperative procedure selection and postoperative surgical evaluation of the hallux abductovalgus deformity, the so-called normal values of these measurements have not been well established. The objectives of the present study were to (1) evaluate the descriptive statistics of the first IMA, HAA, and MSP from a large patient population and (2) to determine an objective basis for defining "normal" versus "abnormal" measurements...
July 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Alper Deveci, Ahmet Firat, Serdar Yilmaz, Ozdamar Fuad Oken, Ahmet Ozgur Yildirim, Ahmet Ucaner, Murat Bozkurt
The present retrospective investigation aimed to determine the factors associated with recurrence of hallux valgus deformity after scarf osteotomy in 50 feet in 43 consecutive patients. We hypothesized that hallux abductovalgus after scarf osteotomy recurs because of the presence of preoperative joint incongruity. The clinical and radiographic findings, including the weightbearing radiographic hallux valgus angle, first intermetatarsal angle, distal metatarsal articular angle, first metatarsophalangeal joint congruence, American Orthopaedic Foot and Ankle Society scores, and pain measured on a visual analog scale, and logistic regression analysis were used to analyze the association of the independent variables with the recurrence of deformity...
November 2013: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Aryan I S Dawoodi, Anthony Perera
BACKGROUND: Metatarsus adductus is a common congenital foot deformity. Variable prevalence values were reported using different techniques in different populations. Numerous radiological measurements have been proposed to assess this deformity with a paucity of studies reporting the reliability of these methods. The metatarsus adductus angle was shown to correlate with the severity of hallux abductovalgus in normal feet and preselected populations of juvenile hallux valgus. MATERIALS AND METHODS: Weight bearing dorsoplantar radiographs of 150 feet were examined for 5 angles commonly used in assessing metatarsus adductus: angle between the second metatarsus and the longitudinal axis of the lesser tarsus (using the 4th or 5th metatarso-cuboid joint as a reference), Engel's angle and modified Engle's angle...
September 2012: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Kym Hennessy, James Woodburn, Martijn P M Steultjens
OBJECTIVE: To identify and critically appraise the evidence for the effectiveness of custom orthoses for the foot and ankle in rheumatoid arthritis. METHODS: Studies were identified in appropriate electronic databases (from 1950 to March 2011). The search term "rheumatoid arthritis" with "foot" and "ankle" and related terms were used in conjunction with "orthoses" and synonyms. Included studies were quantitative longitudinal studies and included randomized controlled trials (RCTs), case-control trials, cohort studies, and case series studies...
March 2012: Arthritis Care & Research
Ryan B Rigby, Lawrence M Fallat, John P Kish
The Austin procedure has become a common method of osteotomy for the correction of hallux abductovalgus when indicated. The V-type configuration is intrinsically stable but not without complications. One complication encountered is rotation and/or displacement of the capital fragment. We present the use of an axial loading screw in conjunction with a dorsally placed compression screw. The benefit to this technique lies in the orientation of the axial loading screw, because it is directed to resist the ground reactive forces while also providing a second point of fixation in a crossing screw design...
September 2011: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Rahn A Ravenell, Craig A Camasta, Donald R Powell
Conventional thinking holds that high intermetatarsal and hallux abductus angles (>15° and >25°, respectively) are associated with a hypermobile first ray and require a Lapidus procedure to achieve satisfactory correction for the treatment of hallux valgus. However, normal first ray motion may be misinterpreted as hypermobility, and it is possible to take advantage of this motion to correct some portion of a large hallux abductovalgus deformity with distal procedures, such as the Austin or first metatarsophalangeal joint fusion...
May 2011: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Sean P Gocke, Francis J Rottier, Robert M Havey, Susan M Renner, Avinash G Patwardhan, Gerard Carandang
Two variations of crescentic shelf osteotomies have been described for the treatment of moderate to severe hallux abductovalgus: a short arm and a long arm. This study tested the hypothesis that the short-arm osteotomy will have a greater moment to failure and angular stiffness than the long arm. Eighteen first metatarsal specimens were dissected from 9 matched pairs of fresh frozen cadaveric specimens. One metatarsal from each pair received a short-arm osteotomy, whereas the other received a long-arm osteotomy...
March 2011: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Wenjay Sung, Andrew J Kluesner, James Irrgang, Patrick Burns, Dane K Wukich
The purpose of this study was to evaluate the radiographic outcomes of primary metatarsophalangeal joint arthrodesis for hallux abductovalgus deformities. Between January 2004 and March 2009, 56 consecutive patients (58 feet) underwent primary arthrodesis of the metatarsophalangeal joint (MTPJ) for severe hallux abductovalgus deformity and or hallux rigidus. Results were assessed by primary radiographic outcome measurements (hallux valgus and first-second intermetatarsal angle). Overall, the mean hallux valgus (HA) angle improved significantly from 31...
September 2010: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Natalie G Taylor, Stuart A Metcalfe
BACKGROUND: The modified Lapidus procedure has been used to treat hallux abducto valgus and degenerative joint disease of the first metatarsocuneiform joint for many years. Historically, the Lapidus has been associated with poor satisfaction due to complications such as non-union. The aim of this study was to review the surgical outcomes of 18 patients using the validated Foot Health Status Questionnaire (FHSQ). The four domains within the FHSQ were all investigated. Pre and post operative angular measurements were also reviewed...
December 2008: Foot
Roland Ramdass, Andrew J Meyr
The standard classification system used to measure the sesamoids in the evaluation of hallux abductovalgus is a uniplanar description of a multiplanar deformity. Additionally, it cannot accurately describe a true measure of sesamoid positional change in the perioperative period because the first metatarsal is laterally transposed during corrective surgery. The intended emphasis of this investigation is to evaluate the sesamoid position in multiple planes relative to a stationary anatomical landmark following first metatarsal osteotomy for the surgical correction of hallux abductovalgus deformity...
January 2010: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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