Hallux valgus treatment

a tridimensional problem

Abstract

Objective: To present a new technique called PROMO, and the results on the first patients operated on. Methods: Six patients were operated with this technique, with an average metatarsophalangeal (MTTP) angle of 35 degrees, intermetatarsal angle (IMA) of 16 degrees and a mean great toe internal malrotation of 35 degrees. The preoperative AOFAS score was 55 points. Radiological and clinical results were recorded, besides any complication. Our average follow up was 7 months. Results: The average postoperative MTTP angle was 5 degrees, the IMA was 4 degrees and the mean great toe internal malrotation was 3 degrees. No metatarsal shortening was observed whatsoever. The postoperative AOFAS score was 85 points with no recurrences. Conclusions: We describe a new technique which corrects not only the metatarsus varus, but also the metatarsal internal rotation, present in almost all Hallux Valgus cases. This is performed by rotating the metatarsal through an oblique plane osteotomy with no bone resection. This new procedure corrects the metatarsal malrotation, known factor that increases the Hallux Valgus recurrence. This technique is easy to remember and relatively simple to perform in primary and revision cases. The authors results show that it is as safe and effective as other procedures, with some advantages to be discussed. Level of evidence: Level V.