First metatarsal double osteotomy for the treatment of moderate to severe hallux valgus

short term results

Abstract

Objective: First metatarsal double osteotomy (FMDO) was originally described for the treatment ofsevere juvenile hallux valgus. This technique is able to correct each component of the deformity.The purpose of this study was to assess the clinical and radiographical results of patientsundergoing a FMDO combined with a closing wedge proximal phalanx osteotomy, for the treatmentof severe and moderate hallux valgus. Methods: Nine patients were assessed with an averagefollow up of 12 months. The clinical and functional results were evaluated through the AOFASscale. Complications were assessed based in our clinical records. Radiographic alignment, timeto fusion and union rate was recorded. Results: The AOFAS average improvement was 53 points(pre surgical average of 34 points and post-surgical average 87 points). 1 case of superficialwound infection and 1 case of painful hardware were registered. The average preoperative halluxvalgus angle (HVA), intermetatarsal angle (IMA), proximal articular set angle (PASA), sesamoidsposition (SP) and first metatarsal length (FML) were 39º, 18º, 10º, E 6 and 1mm. The averagepostoperative was 7º, 4º, 6º, E2, 2mm. The union rate was 100% in an average of 9 weeks.Conclusion: FMDO combined with a closing wedge proximal phalanx osteotomy has a goodcorrective power and allows us to modify each component of the deformity, with a low complicationrate and very good short term results.