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Metatarsal osteotomy

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https://www.readbyqxmd.com/read/29772992/rotational-deformity-of-the-first-ray-precludes-accurate-distal-metatarsal-articular-angle-measurement-in-hallux-valgus
#1
David B Frumberg, Qais Naziri, Robert Pivec, Lee Bloom, Barbara Freeman, Jaime A Uribe
The routine workup of hallux valgus includes measurements of the distal metatarsal articular angle (DMAA). However, this angle may not be a reliable measurement when rotational deformities occur. Eight matched cadaveric feet were evaluated radiographically using fluoroscopy. The intermetatarsal angle (IMA), hallux valgus angle, and DMAA were evaluated as a baseline. Then, we assessed whether axial rotation of 15°, 30°, 45°, and 60° affected the accuracy of the IMA and the DMAA significantly. Statistical evaluation was performed using Student's t tests and analysis of variance...
2018: Journal of Long-term Effects of Medical Implants
https://www.readbyqxmd.com/read/29737368/-minimally-invasive-correction-of-lesser-toe-deformities-and-treatment-of-metatarsalgia
#2
REVIEW
M Thomas, M Jordan
OBJECTIVE: Atraumatic and joint-sparing procedure for the correction of lesser toe deformities by using a linear or perpendicular osteotomy of the proximal and/or middle phalanx of the lesser toes with additional capsulotomies or tendon dissection for soft tissue realignment. Metatarsalgia is addressed via an extracapsular distal metaphyseal crescentic-like metatarsal osteotomy. INDICATIONS: Symptomatic lesser toe deformities, painful pseudoexostosis, metatarsalgia, symptomatic metatarsal malalignment, metatarsus adductus...
May 8, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29729800/proximal-supination-osteotomy-of-the-first-metatarsal-for-hallux-valgus
#3
REVIEW
Ryuzo Okuda
Postoperative recurrence of hallux valgus is a relatively common complication and is associated with unsatisfactory surgical outcomes. Risk factors for postoperative recurrence include a round lateral edge of the first metatarsal head (a positive round sign) and incomplete reduction of the sesamoids. These risk factors may relate to residual pronation of the first metatarsal following surgery. A novel technique of a proximal supination osteotomy, in which varus and pronation of the first metatarsal can be corrected simultaneously, can achieve significant correction in moderate or severe hallux valgus deformity and a low rate of hallux valgus recurrence...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729799/using-the-center-of-rotation-of-angulation-concept-in-hallux-valgus-correction-why-do-we-choose-the-proximal-oblique-sliding-closing-wedge-osteotomy
#4
REVIEW
Emilio Wagner, Cristian Ortiz, Pablo Wagner
Many different surgeries have been proposed for hallux valgus treatment, osteotomies being the currently recommended ones. Because of high recurrence rates, distal, diaphyseal and proximal osteotomies have been used to improve alignment and sesamoid reduction. The center of rotation of angulation (CORA) concept applies to any deformity and helps to completely realign 2 bone segments. When used with proximal osteotomies, bone displacement and angulation is performed obtaining complete deformity correction. The proximal oblique sliding closing wedge (POSCOW) osteotomy follows the CORA concept and permits preoperative planning...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729798/how-do-i-use-the-scarf-osteotomy-to-rotate-the-metatarsal-and-correct-the-deformity-in-three-dimensions
#5
REVIEW
Eric Swanton, Lyndon Mason, Andy Molloy
The scarf osteotomy has become the workhorse procedure for a large proportion of foot and ankle surgeons, especially in Europe, in the treatment of hallux valgus. Such a versatile procedure should not be underestimated, and planning and thought should precede any such procedure. The angle of bone cuts and magnitude of translation dictate the final position, and all movement axes should be given equal attention.
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729797/how-i-use-a-three-dimensional-approach-to-correct-hallux-valgus-with-a-distal-metatarsal-osteotomy
#6
REVIEW
Daniel M G Winson, Anthony Perera
The role of uniplanar osteotomy in correction of multiplanar deformity in hallux valgus is a developing and promising concept. Careful consideration should be given to the literature when considering the concept of preexisting pronation of the metatarsal. Recent weight-bearing computed tomography studies contradict the existing literature and state that there is little or no rotation of the metatarsal; therefore, a multiplanar osteotomy should aim to correct the rotation caused by soft tissue imbalance at the tarsometatarsal and metatarsophalangeal joints rather than in the metatarsal itself...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729795/is-the-rotational-deformity-important-in-our-decision-making-process-for-correction-of-hallux-valgus-deformity
#7
REVIEW
Pablo Wagner, Emilio Wagner
Rotational deformity in hallux valgus is a recognized component and a demonstrated recurrence factor in patients who have undergone surgery. More than 20 years ago, publications started reporting metatarsal pronation as part of the hallux valgus pathology. Identifying metatarsal pronation should be part of the preoperative angular measurements. The proximal metatarsal rotational osteotomy and Lapidus fusion are some of the few techniques that reliably correct metatarsal pronation. They have good results, with more nonunions reported for the Lapidus...
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29729794/comparison-of-three-dimensional-displacement-among-different-metatarsal-osteotomies
#8
REVIEW
Young Yi, Woo-Chun Lee
Hallux valgus is a slowly progressing complex 3-dimensional biomechanical process. Therefore, precise understanding of 3-dimensional deformity is essential for satisfactory clinical result. Uniplanar correction on anteroposterior view of foot would be insufficient, and rotation on frontal plane as well as sagittal alignment should also be well corrected. This article will review the 3-dimensional components of bony displacement in different surgical methods for hallux valgus correction.
June 2018: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29715225/modified-scarf-osteotomy-with-medial-capsule-interposition-for-hallux-valgus-in-rheumatoid-arthritis-a-study-of-cases-including-severe-first-metatarsophalangeal-joint-destruction
#9
Junichi Kushioka, Makoto Hirao, Hideki Tsuboi, Kosuke Ebina, Takaaki Noguchi, Akihide Nampei, Shigeyoshi Tsuji, Shosuke Akita, Jun Hashimoto, Hideki Yoshikawa
BACKGROUND: Arthrodesis of the first metatarsophalangeal (MTP) joint has been recommended for severe hallux valgus deformity in patients with rheumatoid arthritis (RA). However, with the progress of medical treatment of RA, joint preservation surgery has recently been performed. The aim of this study was to investigate the clinical and radiographic outcomes of modified Scarf osteotomy with medial capsule interposition for RA cases including severe destruction of the first MTP joint and to evaluate risk factors for recurrence...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29704103/minimally-invasive-bunionette-correction
#10
REVIEW
G A Morawe, M H T Schmieschek
OBJECTIVE: Bunionette or 'tailor's bunion' is a deformity of the fifth ray, which comes along with a metatarsus quintus valgus and a varus deformity of the fifth toe with subluxation of the metatarsophalangeal joint. A minimally invasive osteotomy of the fifth metatarsal without internal fixation using burrs is an increasingly used alternative for symptomatic tailor's bunion deformity. Similar to open surgery procedures the type of osteotomy complies with the underlying pathology...
April 27, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29685561/anatomic-reconstruction-versus-traditional-rebalancing-in-lesser-metatarsophalangeal-joint-reconstruction
#11
Jeremy J Cook, Lindsay J Johnson, Emily A Cook
Traditional rebalancing techniques, such as capsulotomies and capsulorrhaphies, are commonly performed during complex hammertoe and lesser metatarsal osteotomy procedures involving metatarsophalangeal joint (MTPJ) contractures; however, floating toes, digital instability, and malalignment are concerns. We critically analyzed the outcomes after anatomic reconstruction of the plantar plate and collateral ligaments compared with those after traditional rebalancing techniques. A case-control study was conducted of 54 patients who had undergone surgical correction of lesser MTPJ imbalances due to complex hammertoe deformities (power 80%, type I error = 0...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29671022/-the-minimally-invasive-chevron-and-akin-osteotomy-mica
#12
REVIEW
Sebastian Altenberger, Stefanie Kriegelstein, Oliver Gottschalk, Florian Dreyer, Alexander Mehlhorn, Anke Röser, Markus Walther
OBJECTIVE: Percutaneous correction of a hallux valgus deformity with or without transfer metatarsalgia. INDICATIONS: Hallux valgus deformity up to 20° intermetatarsal angle, without instability of the first tarsometatarsal joint. CONTRAINDICATIONS: Symptomatic arthritis of the first metatarsophalangeal joint, as well as instability of the first tarsometatarsal joint. SURGICAL TECHNIQUE: Percutaneous performed osteotomy of the distal metatarsal 1 in combination with a medial closing wedge osteotomy of the proximal phalanx of the first toe...
April 18, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29652186/surgical-treatment-of-mild-to-severe-hallux-valgus-deformities-with-a-percutaneous-subcapital-osteotomy-combined-with-a-lateral-soft-tissue-procedure
#13
Mauro Maniglio, Paolo Fornaciari, Henrik Bäcker, Emanuel Gautier, Marc Lottenbach
Distal metatarsal (MT) osteotomies have been used in mild or moderate cases of hallux valgus (HV) and proximal MT osteotomy has been considered the treatment of choice for severe deformities. A distal osteotomy could achieve a greater degree of correction by the addition of a distal soft-tissue procedure and be used to treat also severe deformity. Limited evidence about the use of the percutaneous subcapital osteotomy (SCOT); a type of MT osteotomy, in combination of a soft tissue procedure, is available. We evaluated this procedure routinely used in our clinic...
April 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29630032/perineural-versus-systemic-dexamethasone-in-front-foot-surgery-under-ankle-block-a-randomized-double-blind-study
#14
Philippe Marty, Olivier Rontes, Clément Chassery, Corine Vuillaume, Bertrand Basset, Mehdi Merouani, Constance Marquis, Benoit Bataille, Martine Chaubard, Marie Claude Mailles, Fabrice Ferré, Alain Delbos
BACKGROUND AND OBJECTIVES: Among the different adjuvants, dexamethasone is one of the most accepted to prolong the effect of local anesthetics. This study aims to determine the superiority of perineural over systemic dexamethasone administration after a single-shot ankle block in metatarsal osteotomy. METHODS: We performed a prospective, double-blind, randomized study. A total of 100 patients presenting for metatarsal osteotomy with an ankle block were randomized into 2 groups: 30 mL ropivacaine 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29600669/-clinical-effect-modified-chevron-osteotomy-combined-with-lateral-tissue-loosening-in-treating-mild-moderate-hallux-valgus-through-internal-signal-approach
#15
Xue-Qiang Chen, Qun-Feng Wu, Wei-Qin Dong, Li-Xin Yu, Xiong-Feng Li
OBJECTIVE: To explore clinical effect of modified Chevron osteotomy combined with lateral tissue loosening for the treatment of mild-moderate hallux valgus through internal signal approach. METHODS: From July 2015 to June 2016, 26 patients with mild-moderate hallux valgus treated with modified Chevron osteotomy combined with lateral tissue loosening through internal signal approach, including 2 males and 24 females aged from 45 to 65 years old with an average of(54...
March 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29600668/-minimally-invasive-therapy-for-hallux-valgus-with-deformity-of-little-toe-varus
#16
Shi-Wei Gu, Ke Yang, Si-Qiao Zhao, Zhan-Ao Gao, Shun-Qian Ma, Wen-Qing Zhang
OBJECTIVE: To explore clinical effect of minimally corrective osteotomy for the treatment of hallux valgus with deformity of little toe varus through small incision. METHODS: From January 2013 to June 2016, 168 hallux valgus patients with deformity of little toe varus were treated by minimally corrective osteotomy through small incision. Among them, 7 males and 161 females were aged from 22 to 75 years old with an average of(59.3±3.5) years old. Preoperative clinical manifestation mainly focus on red and swollen of bunion, pain around with metatarsal bones, and diagnosed as hallux valgus with deformity of little toe varus through small incision...
March 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29573864/minimally-invasive-distal-linear-metatarsal-osteotomy-combined-with-selective-release-of-lateral-soft-tissue-for-severe-hallux-valgus
#17
Hiroyuki Seki, Yasunori Suda, Kenichiro Takeshima, Tetsuro Kokubo, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Yasuo Niki
BACKGROUND: Minimally invasive techniques for hallux valgus have been widely used to treat mild to moderate hallux valgus deformities. The purpose of this study was to evaluate the clinical and radiographic outcomes of distal linear metatarsal osteotomy (DLMO), which is one of the minimally invasive techniques, for severe hallux valgus. METHODS: 95 patients (141 feet) with severe hallux valgus underwent DLMOs. Lateral soft tissue release (LSTR) was performed at the same time for the cases selected by an original manual test...
March 21, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29554032/efficacy-and-safety-of-intravenous-meloxicam-in-subjects-with-moderate-to-severe-pain-following-bunionectomy-a-randomized-double-blind-placebo-controlled-trial
#18
Richard A Pollak, Ira J Gottlieb, Fardin Hakakian, John C Zimmerman, Stewart W McCallum, Randall J Mack, Rosemary Keller, Alex Freyer, Wei Du
OBJECTIVE: To evaluate the analgesic efficacy and safety of a novel intravenous (IV) formulation of meloxicam (30▒mg) in subjects with moderate-to-severe pain following a standardized, unilateral bunionectomy with first metatarsal osteotomy and internal fixation. METHODS: Subjects who met the criteria for moderate-to-severe postoperative pain were randomized to receive bolus injections of meloxicam IV 30▒mg (n=100) or placebo (n=101) administered once daily...
March 16, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29547029/a-two-stage-foot-repair-in-a-55-year-old-man-with-poliomyelitis
#19
Daniel Pollack
A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub-first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure...
January 2018: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29532741/short-term-radiographic-outcome-after-distal-chevron-osteotomy-for-hallux-valgus-using-intramedullary-plates-with-an-amended-algorithm-for-the-surgical-management-of-hallux-valgus
#20
Takumi Matsumoto, Christopher E Gross, Selene G Parekh
Distal Chevron osteotomy is a well-established surgical procedure for mild to moderate hallux valgus deformity. Many methods have been described for fixation of osteotomy site; secure fixation, enabling large displacement of the metatarsal head, is one of the essentials of this procedure. The purpose of the present study was to evaluate the short-term radiographic outcome of a distal Chevron osteotomy using an intramedullary plate for the correction of hallux valgus deformity. The present study evaluated 37 patients (40 feet) who underwent distal Chevron osteotomy using an intramedullary plate by periodic radiographs obtained preoperatively and at 4 weeks, 8 weeks, 3 months, and 6 months postoperatively...
March 1, 2018: Foot & Ankle Specialist
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