PO 18197 - PROMO technique for hallux valgus treatment

Abstract

Introduction: Hallux valgus (HV) deformity is a prevalent condition that affects several aspects of the foot, causing pain, imbalance, immobility and increased risk of falls. Various osteotomies have been described for HV treatment, and osteotomy is the best option currently available among hundreds of surgical techniques, although no osteotomy is considered better than any other. The incidence of complications is associated with the degree of deformity, which may be defined according to the HV angle, the intermetatarsal angle and the degree of sesamoid subluxation. When the deformity is diagnosed as severe, the risk of recurrence is higher. Wagner et al. (2017) focused on controlling these complex cases and described a technique called Proximal ROtational Metatarsal Osteotomy (PROMO), inspired by the rotational osteotomy for Blount’s disease. Objective: To present the outcomes of 10 cases of severe HV (16 feet) treated using the PROMO technique. Methods: The pre- and postoperative data of 16 consecutive patients treated at a private hospital in São Paulo, SP, were collected. All patients were treated using the PROMO technique described by Wagner et al., and radiographs were taken to measure the parameters and collect records. A calculator programed in Microsoft Excel®, together with a cell phone application, were used to calculate the target angle correction power and osteotomy angle according to a process is described in this study. Results: There was satisfactory improvement in the American Orthopedic Foot and Ankle Society (AOFAS) score and subjective pain in all cases, in addition to a clear resolution of the deformity on physical examination and on radiographs. The union time; complications, such as symptomatic or asymptomatic pseudarthrosis; and angle correction power are also described in the present study. Conclusion: The PROMO technique is a safe and interesting option for the treatment of severe HV that has low rates of complications and a high angle correction power.