Abstract
Aims: The results of arthrodesis of the þrst metatarso-phalangeal joint as salvage procedures after failure in bunion surgery are well documented in the medical literature. Usually, the results may be equivalent to those of primary arthrodeses. On the other hand, joint conserving methods in case of recurrence have not the same reputation in respect to arthrodesis which appears as the gold standard
Methods: We reviewed 27 patients (28 feet) with a mean follow-up of 6.5 years (range: 1–18 years) after treatment for recurrence after bunion surgery. The patients were submitted to a joint conserving procedure on grounds of absence of degenerative condition on the metatarsophalangeal joint. The procedure corrected point by point all the characteristics of the deformity: lateral release, mobilisation of the joint, tightening of the medial capsule and osteotomies on the þrst ray.
Results: Preoperatively valgus of the great toe was on average of 38.9û. At time of follow-up (6.5 years on average) after revisional procedure, valgus of the great toe was on average 21.3û. Postoperatively 23 out of 27 patients were satisþed. The result was considered as good in 20 cases, fair in one, and poor in 7 cases.
Conclusions: In spite of technical difþculties, these results can equal those of primary bunion procedure, if all the morphological disorders are corrected. Conservative methods may be rational when the joint remains ßexible with no pain and when the morphological particularities on the forefoot are sufþciently indisputable so that their correction could cure the patient
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
